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Fasting not always necessary in pediatric dyslipidemia screening

Article

Both the AAP and the American Heart Association recommend that children who are at risk for dyslipidemia have a fasting cholesterol check, but denying food to children, who may not understand what is going on, is different than an adult who foregoes morning coffee until after the blood work. Find out why a new study suggests that fasting may not always be necessary.

Both the the American Academy of Pediatrics and the American Heart Association recommend that children who are at risk for dyslipidemia have a fasting cholesterol check, but denying food to children, who may not understand what is going on, is different than an adult who foregoes morning coffee until after the blood work.

Some new research, however, suggests that fasting may not always be necessary and that it would be appropriate in some circumstances for pediatricians to test immediately during an office visit when the need for screening is discovered.

Researchers compared cholesterol screening results for a nonfasting group of children with results for a similar fasting group and discovered only small differences that they said were “likely not clinically important.”

A nationally representative sample of about 17,000 children and adolescents from the National Health and Nutrition Examination Survey (1999-2006) were used in the study, which sought to confirm whether some parts of cholesterol testing could be done without fasting in children, as is the case in adults. Researchers then examined how results for total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides related to whether the child had fasted.

In young people who had fasted for at least 8 hours, TC and HDL were similar to those who did not fast. LDL was only slightly higher when fasting, but somewhat more variation was seen with triglycerides.

Overweight children had slightly increased mean changes in lipid components per hour of fasting compared to healthy-weight children, but researchers noted that “the degree of these changes was still small relative to overall lipid value results, and there were no statistically significant differences when the changes in cholesterol values according to weight status were compared.” Age of the child also was not a statistically significant factor, they said.

Go back to the current issue of eConsult.

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