Non-fasting Levels Research Articles

Clinical and Prognostic Value of Non-Fasting Lipoproteins and Apolipoproteins in Chinese Patients with Coronary Heart Disease.

Lipid profiles differ naturally between individuals and between populations. So far, the data relating to non-fasting lipid profiles has been derived predominantly from studies on Western population. The characteristics and clinical significance of non-fasting lipids in Chinese patients with coronary heart disease (CHD) in response to traditional Chinese diets remain poorly understood. A total of 1022 Chinese CHD patients with coronary artery luminal stenosis 40% as diagnosed by coronary artery angiography were enrolled in the study. All patients received standard treatment for CHD, including statins. They were divided into an intermediate stenosis group (luminal stenosis 40-70%, n = 486) or a severe stenosis group (luminal stenosis 70%, n = 536). Their blood lipid profiles were measured in the fasting state, and 4 hours after normal breakfast. All participants were followed up for five years. Major adverse cardiovascular events (MACE) including all-cause death, cardiac death, myocardial infarction, unscheduled coronary revascularization and stroke were recorded. After normal breakfast intake, patients with intermediate or severe stenosis showed an apparent increase in the levels of triglyceride (TG), remnant cholesterol (RC) and Apo (apolipoprotein) A1 compared to the fasting state, but a significant reduction in the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), Apo B and Apo E. In addition to the traditional risk factors (older age, male, diabetes and smoking) and coronary artery stenosis, the fasting levels of LDL-C and Apo B, as well as non-fasting levels of HDL-C and Apo A1, were identified as independent predictors of 5-year MACE occurrence by multivariate Cox proportional hazards analysis. Patients in the 1st tertile of the non-fasting HDL-C group ( 0.86 mmol/L) showed a significantly higher risk of MACE than 3rd tertile ( 1.07 mmol/L) (1st tertile: 2.786, 95% CI (confidence intervals) [1.808, 4.293], p 0.001). This prospective observational study found that lipid profiles in either the fasting or non-fasting states were associated with the long-term risk of MACE in Chinese CHD patients. In addition to the fasting LDL-C level, a low non-fasting HDL-C level may also be an independent risk factors for cardiovascular events. Measurement of lipid profiles during the non-fasting state may be feasible for the management of CHD patients in routine clinical practice in China.

Comparison between Fasting and Non-Fasting Cut-Off Values of Triglyceride in Diagnosing High Triglyceride in Chinese Hypertensive Outpatients

Background: Hypertension (HBP) often occurs together with hypertriglyceridemia which indicates elevated triglyceride (TG) and remnant cholesterol (RC) levels. Non-fasting (i.e., postprandial) blood lipid test after a daily meal has been recommended by the European Atherosclerosis Society (EAS). However, little is known about the difference between fasting and non-fasting cut-off values in assessing high TG (HTG) and high RC (HRC) in HBP outpatients. Methods: 225 Chinese outpatients with HBP, including 119 fasting patients (i.e., fasting group) and 106 non-fasting patients (i.e., non-fasting group) were enrolled in this study. Non-fasting levels of blood lipids at 2 h after a daily breakfast were also tested in 33 patients among the fasting group. Venous blood samples were collected. Results: The non-fasting group had significantly higher levels of TG and RC while lower levels of total cholesterol, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol than the fasting group (p < 0.05). According to the TG and RC cut-off values of the EAS, the percentages of HTG and HRC in the non-fasting group were 72.6% and 70.8%, respectively, whereas those in the fasting group were 57.1% and 52.9%, respectively. According to the cut-off value of marked HTG commonly used in the Chinese population in clinical practice, the percentage of marked HTG in the non-fasting group was 57.5%, whereas that in the fasting group was 34.5%. However, the percentages of HTG (57.6% vs. 51.5%) and HRC (51.5% vs. 51.5%) marked HTG (30.3% vs. 33.3%) in the fasting state and at 2 h after a daily breakfast in 33 outpatients did not reach statistical significance. Conclusion: Non-fasting blood lipid tests could find more individuals with HTG as well as those with marked HTG among Chinese outpatients with HBP. It indicates that non-fasting blood lipid tests are worth being recommended in patients with HBP.

Community Survey on Blood Pressure and Levels of Blood Glucose, Cholesterol and Uric Acid Among People 45 Years and Above in Rural Villages of Bali

OBJECTIVE. To observe the proportion of high blood pressure and high blood glucose, cholesterol and uric acid among people aged 45 years and older at the rural villages of Pejeng, Samplangan and Petak, in Gianyar Regency, Bali.&#x0D; METHODS. The survey’s samples were all persons aged 45 years and over who came voluntarily to participate in the survey. Blood pressure was measured by mercury sphygmomanometer (Nova). Non-fasting levels of serum glucose, cholesterol, and uric acid were assessed by rapid test method using Easy Touch CGU apparatus. Each parameter studied was categorized as “high” and “normal” (blood pressure high: ≥140/90 mmHg; blood cholesterol high: ≥200mg/dl; blood glucose high ≥200mg/dl; blood uric acid high: &gt;7.0 mg/dl, while other measurements below those values were categorized as normal. Data were analyzed descriptively and presented in tables of frequencies.&#x0D; RESULTS. A total of 650 people aged 45 years and above participated in the survey (Samplangan village: 157 people, Pejeng village: 168 people, Petak village: 225 people). Of 650 study subjects examined, 43.8% had high serum cholesterol, 22.8% had high blood pressure, 26.3% had high serum uric acid, and 9.8% had high blood glucose. According to gender, 49.5% males and 38.2% females had high blood cholesterol, 27.3% males and 20.5% females had high blood pressure, 38.4% males and 20.3% females had high blood uric acid, and 11.1% males and 9.4% females had high blood glucose, respectively&#x0D; CONCLUSIONS. In respective three villages greatest proportion of the study subjects had high serum cholesterol, followed in order of decreasing proportions by either high blood pressure or high blood uric acid, and the lowest proportion was with high blood glucose.

Fasting status modifies the association between triglyceride and all-cause mortality: A cohort study.

Background and AimsBoth fasting and non‐fasting levels of triglyceride have been shown positively associated with all‐cause mortality. It is unknown whether fasting status modifies this association. This study aimed to address this question.MethodsThis study included 34,512 US adults (27,036 fasting and 7476 nonfasting participants). All‐cause mortality was ascertained by linkage to the National Death Index records. Cox proportional hazards models were used to estimate hazard ratios of triglyceride for mortality.ResultsThis cohort was followed up for a mean of 13.0 years. During the follow‐up, 8491 all‐cause deaths were recorded. A 1‐natural‐log‐unit increase in triglyceride was associated with an 8% higher multivariate‐adjusted risk of all‐cause mortality. Interaction analyses showed that fasting status interacted with triglyceride in predicting all‐cause mortality. Sub‐analyses showed that a 1‐natural‐log‐unit increase in triglyceride was associated with a 17% higher multivariate‐adjusted risk of all‐cause mortality in the nonfasting subcohort; however, there lacked such an association in the fasting sub‐cohort. Similarly, high (200–499 mg/dL) and very high levels of triglyceride (≥500 mg/dL) were associated with higher all‐cause mortality risks compared with low normal triglyceride (<100 mg/dL) only in the nonfasting subcohort.ConclusionThis study found that, compared to fasting triglyceride, nonfasting triglyceride was more sensitive in predicting all‐cause mortality. This study supports the initiatives by some guidelines to recommend the use of nonfasting triglycerides for risk assessment.

Non-fasting Changes in Blood Lipids After Three Daily Meals Within a Day in Chinese Inpatients With Cardiovascular Diseases.

BackgroundNon-fasting (i.e., postprandial) lipid detection is recommended in clinical practice. However, the change in blood lipids in Chinese patients with cardiovascular diseases after three daily meals has never been reported yet.MethodsSerum levels of blood lipids were measured or calculated in 77 inpatients (48 men and 29 women) at high or very high risk of atherosclerotic cardiovascular disease (ASCVD) in the fasting state and at 4 h after three meals within a day according to their diet habits.ResultsFemale patients showed significantly higher level of high-density lipoprotein cholesterol (HDL-C) than male patients, and the gender difference in other lipid parameters did not reach statistical significance at any time-point. Levels of triglyceride (TG) and remnant cholesterol (RC) increased, while that of low-density lipoprotein cholesterol (LDL-C) decreased significantly after three meals (p < 0.05). Levels of HDL-C, total cholesterol (TC), and non-high-density lipoprotein cholesterol (non-HDL-C) showed smaller changes after three meals. Percent reductions in the non-fasting LDL-C levels after lunch and supper were around 20%, which were greater than that after breakfast. The percent reductions in the non-fasting non-HDL-C levels after three meals were smaller than those in the non-fasting LDL-C levels. Patients with TG level ≥ 2.0 mmol/L (177 mg/dL) after lunch had significantly greater absolute reduction of LDL-C level than those with TG level < 2.0 mmol/L (177 mg/dL) after lunch [–0.69 mmol/L (–27 mg/dL) vs. –0.36 mmol/L (–14 mg/dL), p<0.01]. There was a significant and negative correlation between absolute change in LDL-C level and that in TG level (r = −0.32) or RC level (r = −0.67) after lunch (both p<0.01).ConclusionLDL-C level decreased significantly after three daily meals in Chinese patients at high or very high risk of ASCVD, especially when TG level reached its peak after lunch. Relatively, non-HDL-C level was more stable than LDL-C level postprandially. Therefore, when LDL-C level was measured in the non-fasting state, non-HDL-C level could be evaluated simultaneously to reduce the interference of related factors, such as postprandial hypertriglyceridemia, on detection.

Ambient particulate matter exposure interacts with abdominal obesity to increase blood triglycerides

Abstract Background Blood lipids levels dysregulation represent potential mechanism intermediating the adverse cardiovascular effects of ambient particulate matter (PM) exposure. The present study aims to estimate the effect of particulate matter (PM10) exposure on blood lipid levels (TC, Total Cholesterol; HDL-C, High-Density Lipoprotein Cholesterol; LDL-C, Low-Density Lipoprotein Cholesterol; TG, Triglycerides) in the adult Portuguese mainland population and to assess the potential mediation and/or modification action of abdominal obesity on this effect. Methods We used data from 2390 participants of the 1st Portuguese Health Examination Survey (INSEF, 2015) with available data on blood lipids parameters and living within a 30km radius of an air quality monitoring station with available PM10 measurements. PM10 concentrations were acquired from the air quality monitoring network of the Portuguese Environment Agency. Generalized linear models were used to assess the effect of 1-year PM10 exposure on blood lipids values. An interaction term was introduced in the models to test the modification action of abdominal obesity. Results We found an association between long-term exposure to PM10 and non-fasting blood TG levels after adjustment for age, sex, education, occupation, lifestyles related variables and temperature but only in participants with abdominal obesity (1.84% TG increase per each 1 µg/m3 PM10 increment, 95% CI: 0.02%; 3.69%) which is well supported by the sensitivity analysis. Conclusions Our study demonstrate that even at low levels of exposure, long-term PM10 exposure interacts with abdominal obesity to increase blood TG levels. To the best of our knowledge, this is the first study showing the modification action of abdominal obesity regarding the PM10 effect on a blood lipid parameter. Our findings suggest that reducing both abdominal obesity prevalence and PM10 below current standards would result in additional health benefits for the population. Key messages Long-term PM10 exposure interacts with abdominal obesity to increase non-fasting blood triglycerides levels by about 2% per each 1 µg/m3 PM10 increase. Reducing both abdominal obesity prevalence and PM10 below current standards would result in additional health benefits for the population.

Serum metabolomic biomarkers of perceptual speed in cognitively normal and mildly impaired subjects with fasting state stratification

Cognitive decline is associated with both normal aging and early pathologies leading to dementia. Here we used quantitative profiling of metabolites involved in the regulation of inflammation, vascular function, neuronal function and energy metabolism, including oxylipins, endocannabinoids, bile acids, and steroid hormones to identify metabolic biomarkers of mild cognitive impairment (MCI). Serum samples (n = 212) were obtained from subjects with or without MCI opportunistically collected with incomplete fasting state information. To maximize power and stratify the analysis of metabolite associations with MCI by the fasting state, we developed an algorithm to predict subject fasting state when unknown (n = 73). In non-fasted subjects, linoleic acid and palmitoleoyl ethanolamide levels were positively associated with perceptual speed. In fasted subjects, soluble epoxide hydrolase activity and tauro-alpha-muricholic acid levels were negatively associated with perceptual speed. Other cognitive domains showed associations with bile acid metabolism, but only in the non-fasted state. Importantly, this study shows unique associations between serum metabolites and cognitive function in the fasted and non-fasted states and provides a fasting state prediction algorithm based on measurable metabolites.

Comparison of the Reductions in LDL-C and Non-HDL-C Induced by the Red Yeast Rice Extract Xuezhikang Between Fasting and Non-fasting States in Patients With Coronary Heart Disease.

Background: Xuezhikang, an extract of red yeast rice, effectively lowers fasting blood lipid levels. However, the influence of Xuezhikang on the non-fasting levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) has not been explored in Chinese patients with coronary heart disease (CHD).Methods: Fifty CHD patients were enrolled and randomly divided into two groups (n = 25 each) to receive 1,200 mg/d of Xuezhikang or a placebo for 6 weeks as routine therapy. Blood lipids were repeatedly measured before and after 6 weeks of treatment at 0, 2, 4, and 6 h after a standard breakfast containing 800 kcal and 50 g of fat.Results: The serum LDL-C levels significantly decreased, from a fasting level of 3.88 mmol/L to non-fasting levels of 2.99, 2.83, and 3.23 mmol/L at 2, 4, and 6 h, respectively, after breakfast (P < 0.05). The serum non-HDL-C level mildly increased from a fasting level of 4.29 mmol/L to non-fasting levels of 4.32, 4.38, and 4.34 mmol/L at 2, 4, and 6 h post-prandially, respectively, and the difference reached statistical significance only at 4 and 6 h after breakfast (P < 0.05). After 6 weeks of Xuezhikang treatment, the patients had significantly lower fasting and non-fasting serum levels of LDL-C and non-HDL-C (P < 0.05) than at pretreatment. The LDL-C levels were reduced by 27.8, 28.1, 26.2, and 25.3% at 0, 2, 4, and 6 h, respectively, and the non-HDL-C levels were reduced by 27.6, 28.7, 29.0, and 28.0% at 0, 2, 4, and 6 h, respectively, after breakfast. No significant difference was found in the percent reductions in the LDL-C and non-HDL-C levels among the four different time-points.Conclusions: Six weeks of Xuezhikang treatment significantly decreased LDL-C and non-HDL-C levels, with similar percent reductions in fasting and non-fasting states in CHD patients, indicating that the percent change in non-fasting LDL-C or non-HDL-C could replace that in the fasting state for evaluation the efficacy of cholesterol control in CHD patients who are unwilling or unable to fast.

Comparison of fasting and post prandial lipid profile in patients of IHD

Background: Despite recent advancements in medical services and treatment regimens, ischemic heart disease (IHD) is still the leading cause of death in both developed and developing countries. While hypercholesterolemia and hypertriglyceridemia are considered separate risk factors, most recent research in this area have focused at fasting lipids and lipoproteins. Aims and Objectives: To compare the fasting and post prandial lipid profile in patients of IHD.Materials and Method: Upon receiving informed consent, 50 patients with IHD who were reporting to the Department of Medicine were enrolled in the current study. A previous history of myocardial infarction, ECG data, echocardiography, coronary artery bypass grafting surgery, or a coronary angiogram is used to diagnose CHD. For at least six months prior to the study, all of these patients had been free of some clinical incident. Both of the enrolled patients were given a thorough clinical review, with the results being entered into a prestructured proforma. After a twelve-hour overnight fast and two hours after a mixed diet, each subject's venous blood was obtained aseptically. Fasting samples and postprandial (PP) samples were analyzed for lipid profile and blood sugar; blood sugar was measured in 2 hour PP samples and lipids in 4 hour PP samples. Results: Tobacco chewing (30%) was the most common risk factor observed followed by smoking and hypertension (20%). It was observed that mean fasting sugar level of the study subjects was 85.40±21.25mg/dl while post prandial sugar level was 112.60±24.50mg/dl. It was observed that mean fasting triglycerides was 210.02±63.9mg/dl and mean post prandial triglycerides 275.65±48.0mg/dl and the difference was statistically significant. Fall in post prandial total cholesterol (229.72±53.9mg/dl) was observed as compared to fasting level (245.87±64.5mg/dl) but the difference observed was not statistically significant. Mean fasting HDL was 42.71±4.9mg/dl while mean post prandial HDL was 40.65±3.6mg/dl. It was seen that mean fasting LDL was 156.45±23.9mg/dl and mean post prandial LDL was 145.76±31.5mg/dl. It was observed that post prandial VLDL levels (41.76±28.55) were raised as compared to fasting VLDL levels (37.90±17.6) but the difference was not statistically significant. Conclusion: Except for TG, which was statistically significant higher post-prandially, there was no significant clinical disparity between fasting and nonfasting levels of total cholesterol, HDL, or LDL.

High Fat-High Fructose Diet-Induced Changes in the Gut Microbiota Associated with Dyslipidemia in Syrian Hamsters.

Aim: The objective of this study was to characterize the early effects of high fructose diets (with and without high fat) on both the composition of the gut microbiota and lipid metabolism in Syrian hamsters, a reproducible preclinical model of diet-induced dyslipidemia. Methods: Eight-week-old male hamsters were fed diets consisting of high-fat/high-fructose, low-fat/high-fructose or a standard chow diet for 14 days. Stool was collected at baseline (day 0), day 7 and day 14. Fasting levels of plasma triglycerides and cholesterol were monitored on day 0, day 7 and day 14, and nonfasting levels were also assayed on day 15. Then, 16S rRNA sequencing of stool samples was used to determine gut microbial composition, and predictive metagenomics was performed to evaluate dietary-induced shifts in deduced microbial functions. Results: Both high-fructose diets resulted in divergent gut microbiota composition. A high-fat/high-fructose diet induced the largest shift in overall gut microbial composition, with dramatic shifts in the Firmicute/Bacteroidetes ratio, and changes in beta diversity after just seven days of dietary intervention. Significant associations between genus level taxa and dietary intervention were identified, including an association with Ruminococceace NK4A214 group in high-fat/high-fructose fed animals and an association with Butryimonas with the low-fat/high-fructose diet. High-fat/high-fructose feeding induced dyslipidemia with increases in plasma triglycerides and cholesterol, and hepatomegaly. Dietary-induced changes in several genus level taxa significantly correlated with lipid levels over the two-week period. Differences in microbial metabolic pathways between high-fat/high-fructose and low-fat/high-fructose diet fed hamsters were identified, and several of these pathways also correlated with lipid profiles in hamsters. Conclusions: The high-fat/high-fructose diet caused shifts in the host gut microbiota. These dietary-induced alterations in gut microbial composition were linked to changes in the production of secondary metabolites, which contributed to the development of metabolic syndrome in the host.

Nonfasting Lipid Profile May Suffice to Manage Dyslipidemia.

Patients with major mental illness and especially those who receive antipsychotic drugs are at increased risk of metabolic syndrome. Dyslipidemia is part of the metabolic syndrome. Dyslipidemia is associated with an increased risk of cardiovascular, cerebrovascular, and other diseases. A fasting lipid profile is traditionally ordered to determine the need for and to monitor lipid-lowering treatment. However, a recent study showed that fasting and nonfasting lipid levels, obtained from the same patients, almost identically predicted hard 3-year cardiovascular event risks; the risks with fasting and nonfasting levels were closely similar in various secondary analyses, as well. This supports the stance of major medical associations in the field to accept nonfasting lipid levels to guide the treatment of dyslipidemia in the primary and secondary prevention of cardiovascular and cerebrovascular disease events.

Comparison of nonfasting and fasting lipoprotein subfractions and size in 15,397 apparently healthy individuals: An analysis from the VITamin D and OmegA-3 TriaL

Elevated postprandial triglycerides reflect a proatherogenic milieu, but underlying mechanisms are unclear. We examined differences between fasting and nonfasting profiles of directly measured lipoprotein size and subfractions to assess if postprandial triglycerides reflected increases in very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL) and remnants, or small dense lipid depleted LDL (sdLDL) particles. We conducted a cross-sectional analysis of 15,397 participants (10,135 fasting; 5262 nonfasting [<8hours since last meal]) from the VITamin D and OmegA-3 TriaL. Baseline cholesterol subfractions were measured by the vertical auto profile method and particle subfractions by ion mobility. We performed multivariable linear regression adjusting for cardiovascular and lipoprotein-modifying risk factors. Mean age (SD) was 68.0years (±7.0), with 50.9% women. Adjusted mean triglyceride concentrations were higher nonfasting by 17.8±1.3%, with higher nonfasting levels of directly measured VLDL cholesterol (by 3.5±0.6%) and total VLDL particles (by 2.0±0.7%), specifically large VLDL (by 12.3±1.3%) and medium VLDL particles (by 5.3±0.8%), all P<.001. By contrast, lower concentrations of low density lipoprotein (LDL) and IDL cholesterol and particles were noted for nonfasting participants. sdLDL cholesterol levels and particle concentrations showed no statistically significant difference by fasting status (-1.3±2.1% and 0.07±0.6%, respectively, P>.05). Directly measured particle and cholesterol concentrations of VLDL, not sdLDL, were higher nonfasting and may partly contribute to the proatherogenicity of postprandial hypertriglyceridemia. These differences, although statistically significant, were small and may not fully explain the increased risk of postprandial hypertriglyceridemia.

Comparison of the nonfasting and fasting lipid profiles of the patients admitted in the cardiology department of a tertiary hospital in Bangladesh

Background: Evidence relaxes the obligation of fasting for a lipid profile test. There is a scarcity of data comparing the fasting and nonfasting lipid profiles in our setting. Objectives: We conducted this study to observe the differences in the components of the lipid profile between the nonfasting and fasting states. Materials and Methods: In this cross-sectional study, 275 patients admitted in the cardiology department of a tertiary hospital in Bangladesh were evaluated; the study participants were categorized as having an acute myocardial infarction (AMI), unstable angina (UA), and no acute coronary syndrome (non-ACS). Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were measured in both nonfasting and fasting states in all. Results: All the measured components of the lipid profile, e.g., serum TC, HDL-C, LDL-C, and TG, were higher in the nonfasting state than the fasting state in the study participants with AMI. However, those with UA and those without ACS (non-ACS) had no significant differences in fasting and nonfasting levels of TC, HDL-C, and LDL-C through their TG level was significantly higher in the nonfasting state. Conclusion: Nonfasting blood sample, which is more convenient, may be used for assessing the lipid profile in the majority of the patients advised for the test.

Comparison of Fasting and Non-fasting Lipid Profile in Young Healthy Adults

Background and Aim: It is necessary to find out whether fasting blood samples are must for lipid profile determination. Aim of this study to find out is there any difference between fasting and non-fasting lipid profile in young healthy adults. Methods: This study was done on 100 MBBS students of medical college. Lipid profile was done in these healthy young adults for fasting and postprandial statuses. Results: The lipid profile parameters were compared in both the groups of fasting and postprandial statuses. In fasting group, the mean total cholesterol level was 192.1 mg/dl and mean postprandial total cholesterol level was 194.98 mg/dl (P = 0.0407). The mean fasting serum triglyceride level was 121.16 mg/dl and mean postprandial serum triglyceride level was 126.18 mg/dl (P = 0.0001). The mean fasting high density lipoprotein (HDL) level was 45.08 mg/dl and mean postprandial HDL was 43.84 mg/dl (P = 0.0656). The mean fasting serum VLDL level was 24.23 mg/dl and mean postprandial VLDL level was 25.24 mg/dl (P = 0.0001). The mean fasting LDL was 122.8 mg/dl and mean postprandial LDL was 125.9 mg/dl (P = 0.0416). Conclusion: Finally, from this study we found that there is no significant clinical difference between fasting and non-fasting levels of total cholesterol, HDL, LDL, VLDL and TG. Thus, for estimation of lipid profile we can use the blood samples at any time or irrespective of mealtime.

Association of Cardiac Events with Fasting or Nonfasting Lipid Testing

Based on several population-level analyses of the association of cardiac events with fasting and nonfasting lipid levels, several guidelines now

2016-P: High Dose DACRA Treatment Improves Glucose Homeostasis, without Additional Weight Loss

KBP is a Dual Amylin and Calcitonin Receptor Agonist (DACRA). DACRAs have shown efficacy on weight loss and glucose control in rats. However, it is unclear whether the maximum effect has been reached. High Fat Diet (HFD, 60% fat) fed male Sprague-Dawley rats entered a dose escalation regimen ending at 5 (normal dose), 50 or 500 µg/kg daily KBP (n=10/group). Male ZDF (fa/fa) rats received identical doses without dose escalation in a preventive study setup (n=9-10/group). In HFD rats, KBP treatment resulted in a transient decrease in food intake at each dose escalation step. At study end, KBP treatment resulted in a significant weight loss of 77-94 g (13-16%, P&amp;lt;0.0001) compared to vehicle. Furthermore, KBP reduced the weight of adipose tissues (P&amp;lt;0.05). Surprisingly, there was a trend of 5 µg/kg KBP causing a more pronounced adipose-specific weight loss compared to 500 µg/kg (subcutaneous 1.7 vs. 0.7 g, visceral 4.1 vs. 2.5 g adipose weight loss). During two OGTTs, KBP treatment significantly lowered blood glucose (BG) and insulin levels compared to vehicle indicating improved glucose tolerance. Lastly, 24h fecal energy loss increased by KBP treatment, though this trend was absent when accounting for food intake and total feces output. In ZDF rats, KBP treatment significantly improved fasting BG (endpoint vehicle 29.5, endpoint KBP average 18.3 mmol/L, tAUC P&amp;lt;0.0001) and HbA1c (vehicle 10.2%, KBP average 6.1%, P&amp;lt;0.0001) compared to vehicle, with no significant difference between treatment groups. Importantly, fasting and non-fasting insulin levels of KBP-treated rats were increased compared to vehicle in a dose-dependent manner during an OGTT, resulting in lowered BG levels. Increased insulin levels suggest that KBP protects against the known β-cell degradation in the ZDF model. Taken together, these data suggest that higher doses of KBP than previously investigated may preserve insulin secretion to a greater extent. With respect to weight loss, no additional benefit was observed from the high doses. Disclosure N. Sonne: None. A.T. Larsen: None. K.V. Andreassen: Employee; Self; Nordic Bioscience. M.A. Karsdal: Employee; Self; Nordic Bioscience. K. Henriksen: Employee; Self; Nordic Bioscience. Employee; Spouse/Partner; Novo Nordisk A/S. Stock/Shareholder; Self; Nordic Bioscience. Other Relationship; Self; Nordic Bioscience.

Association of Nonfasting vs Fasting Lipid Levels With Risk of Major Coronary Events in the Anglo-Scandinavian Cardiac Outcomes Trial–Lipid Lowering Arm

Recent guidelines have recommended nonfasting for routine testing of lipid levels based on comparisons of nonfasting and fasting populations. However, no previous study has examined the association of cardiovascular outcomes with fasting vs nonfasting lipid levels measured in the same individuals. To compare the association of nonfasting and fasting lipid levels with prospectively ascertained coronary and vascular outcomes and to evaluate whether a strategy of using nonfasting instead of fasting lipid level measurement would result in misclassification of risk for individuals undergoing evaluation for initiation of statin therapy. This post hoc prospective follow-up of a randomized clinical trial included 8270 of 10 305 participants from the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA) with nonfasting and fasting lipid levels measured 4 weeks apart (including 6855 participants with no prior vascular disease) (median follow-up, 3.3 years; interquartile range, 2.8-3.6 years). Data were collected from February 1, 1998, to December 31, 2002, and analyzed from February 1, 2016, to November 30, 2018. Multivariable Cox models, adjusted for cardiovascular risk factors, were calculated for 40-mg/dL (1-mmol/L) higher values of nonfasting and fasting lipids. The trial's primary end point consisted of major coronary events (nonfatal myocardial infarction [MI] and fatal coronary heart disease [212 events]). Secondary analyses examined atherosclerotic cardiovascular disease (ASCVD) events (including MI, stroke, and ASCVD death [351 events]). Among the 8270 participants (82.1% male; mean [SD] age, 63.4 [8.5] years), nonfasting samples had modestly higher triglyceride levels and similar cholesterol levels compared to fasting samples. Associations of nonfasting lipid levels with coronary events were similar to those for fasting lipid levels. For example, adjusted hazard ratios (HRs) per 40-mg/dL of low-density lipoprotein cholesterol were 1.32 (95% CI, 1.08-1.61; P = .007) for nonfasting levels and 1.28 (95% CI, 1.07-1.55; P = .008) for fasting levels. For the primary prevention group, adjusted HRs were 1.42 (95% CI, 1.13-1.78; P = .003) for nonfasting levels and 1.37 (95% CI, 1.11-1.69; P = .003) for fasting levels. Results were consistent by randomized treatment arm (atorvastatin calcium, 10 mg/d, or placebo) and similar for ASCVD events. Concordance of fasting and nonfasting lipid levels for classifying participants into appropriate ASCVD risk categories was high (94.8%). Measurement of nonfasting and fasting lipid levels yields similar results in the same individuals for association with incident coronary and ASCVD events. These results suggest that routine measurement of nonfasting lipid levels may help facilitate ASCVD risk screening and treatment, including consideration of when to initiate statin therapy.

Non-fasting High-Density Lipoprotein Is Associated With White Matter Microstructure in Healthy Older Adults.

A growing body of evidence indicates that biomarkers of cardiovascular risk may be related to cerebral health. However, little is known about the role that non-fasting lipoproteins play in assessing age-related declines in a cerebral biomarker sensitive to vascular compromise, white matter (WM) microstructure. High-density lipoprotein cholesterol (HDL-C) is atheroprotective and low-density lipoprotein cholesterol (LDL-C) is a major atherogenic lipoprotein. This study explored the relationships between non-fasting levels of cholesterol and WM microstructure in healthy older adults. A voxelwise and region of interest approach was used to determine the relationship between cholesterol and fractional anisotropy (FA). Participants included 87 older adults between the ages of 59 and 77 (mean age = 65.5 years, SD = 3.9). Results indicated that higher HDL-C was associated with higher FA in diffuse regions of the brain when controlling for age, sex, and body mass index (BMI). HDL-C was also positively associated with FA in the corpus callosum and fornix. No relationship was observed between LDL-C and FA. Findings suggest that a modifiable lifestyle variable associated with cardiovascular health may help to preserve cerebral WM.

Abstract MP54: Sex-Related Differences in the Association of Social Isolation With Plasma Leptin Concentration

Introduction: Studies have reported a positive associations of depression and psychosocial stress and plasma leptin concentration. Social isolation has been linked to increased leptin signaling in male rats, but this association has not been investigated in humans. Methods: We investigated the cross-sectional association of social isolation and plasma leptin concentration among 2,729 Framingham Offspring Cohort participants at the 7 th examination (1999-2001, mean age = 60.1 years, 42% men). Social isolation was measured using the Berkman-Syme Social Network Index: we assigned 1 point for being married, 1 point each for &gt;2 close friends and &gt;2 close relatives, 1 point for participation is social groups, and 1 point for participation in religious meetings ≥1-2 times per month. Social isolation was defined as a total of 0 points. Non-fasting plasma leptin levels were measured using a commercial immunoassay. The primary outcome was plasma leptin concentration. Secondary outcomes included caloric intake, measured by food frequency questionnaire, and volumes of abdominal subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT), measured by CT among 1,210 of the subjects between 2002 and 2005. Leptin concentration and adipose tissue volume were log-transformed due to skewed distributions. We estimated the associations of social isolation with all outcomes using linear regression. Models included age, body mass index, years of education, smoking status, physical activity index, hypertension, high blood glucose, and CES-D score as covariates. Because leptin levels and responses to social stress may vary among men and women, analyses were stratified by sex. Results: Socially isolated participants were younger and had higher CES-D scores than those who were not. Other characteristics were similar between the two groups. Plasma leptin concentration was 20% lower among socially isolated men (95% CI: -31, -6%) compared with men who were not isolated. Social isolation was also associated with lower caloric intake as well (β = -144.5 kcal, 95% CI: -287.1, -1.87 kcal). Among the subset of men for whom we had adipose tissue depot volume measurements (n=552), VAT volume appeared to be 10% lower among socially isolated men compared with non-isolated men (95% CI: -19, 1%), but this was not true of SAT (β = 1%, 95% C: -9, 10%). We did not observe differences in leptin concentration (β = -1%, 95% CI: -10, 15%), caloric intake (β = -39.1 kcal, 95% CI: -136.0, 57.7 kcal) or SAT β=4%, 95% CI: -3, 14%) according to social isolation among women. Socially isolated women appeared to have higher VAT (β = 10, 95% CI: -1, 10%) Conclusions: In our population of middle-aged and older adults, social isolation was associated with lower leptin levels among men, but not women. The lower leptin concentration observed among isolated men may reflect decreased caloric intake in response to social stress.

Comparison of fasting and non-fasting blood lipid levels in children in Tianjin

Objective To compare the difference between fasting blood lipids and non-fasting blood lipids in children in Tianjin, and to explore the feasibility of non-fasting blood lipids detection in children. Methods A total of 223 child patients were enrolled in Department of Pediatrics, the Second Hospital of Tianjin Medical University from January 2017 to February 2018, fasting and 1-6 h post-dining blood samples were collected from each patient.Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured.Self-control methods were used.Wilcoxon signed rank test was used for statistical analysis. Results Compared with fasting lipids, non-fasting TC increased with 0.02 mmol/L, TG increased with 0.01 mmol/L, HDL-C increased with 0.03 mmol/L, while LDL-C decreased with 0.01 mmol/L, but non-high-density lipoprotein cholesterol did not change.Among them, only the difference in HDL-C between the fasting and non-fasting was statistically significant (Z=-2.870, P<0.05). The difference in the change rate of all indicators was <3%.According to the dyslipidemia group comparison, the differences in hypercholesterolemia (0.72 mmol/L, Z=-2.551, P=0.011), hypertriglyceridemia (0.73 mmol/L, Z=-3.846, P<0.001), low high-density lipoprotein cholesterolemia (-0.04 mmol/L, Z=-8.625, P<0.001) and normal level HDL-C (0.1 mmol/L, Z=-5.040, P<0.001)between non-fasting lipids and fasting blood lipids were statistically significant. Conclusions The change of children′s blood lipid profile in fasting and non-fasting conditions is little.Lipid testing in children does not require fasting.Blood tests can be performed at any appropriate time point in the normal diet. Key words: Non-fasting blood lipid; Blood lipid; Cardiovascular disease; Child