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Fasting not required for metabolic syndrome assessment
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Metabolic syndrome severity may influence the risk for coronary heart disease and diabetes both when it is evaluated in a fasting state and a nonfasting state, according to findings published in Nutrition, Metabolism and Cardiovascular Diseases.
“It remains important to assess patients for risk of future chronic disease and to educate and motivate patients toward lifestyle change to reduce risk,” Mark D. DeBoer, MD, MSc, MCR, associate professor of pediatrics in the division of pediatric endocrinology at the University of Virginia in Charlottesville, Virginia, told Endocrine Today. “These findings increase the number of potential opportunities to make such an assessment and use the data for clinical decisions.”
DeBoer and colleagues collected measurements of triglycerides, HDL cholesterol, glucose, waist circumference and blood pressure were collected from 8,555 adults aged 45 to 64 years (mean age, 53.8 years; 56% women) by and used the data to determine a metabolic syndrome severity score. These measurements were taken at visits conducted between 1987 and 1989, 1990 and 1992, 1993 and 1995, and 1996 and 1998. Among the total study population, 8,072 had measurements taken in a fasting state while the remaining 483 did not fast prior to at least one study visit. The researchers then assessed CHD and diabetes development among participants until Dec. 31, 2011.
According to the researchers, assessment of metabolic syndrome severity was similar among those who fasted and those who did not, except for those who did not fast prior to visits between 1996 and 1998. The researchers observed that metabolic syndrome severity scores were associated with CHD risk both for those who fasted prior to the first visit (HR = 1.53; 95% CI, 1.42-1.66) and those who did not fast at any visit (HR = 1.28; 95% CI, 1.08-1.51). When adjusting the scores by excluding glucose or putting limits of 4.5 mmol/L for triglycerides and 13.9 mmol/L for glucose, the researchers said the findings did not change, while adding that there was also little difference in the association between metabolic severity score and diabetes risk for those who fasted (OR = 3.1; 95% CI, 2.88-3.35) and those who did not (OR = 1.92; 95% CI, 1.05-3.51).
“This is important because many patients are not fasting at clinic visits, and there can be difficulties in arranging a fasting blood draw,” DeBoer said. “These results suggest utility in assessing risk even from a nonfasting sample, with an emphasis on taking advantage of clinical opportunities regardless of fasting status.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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