This study tested the hypotheses that 1- lipid levels change only marginally in response to normal food intake and that 2- nonfasting lipid levels predicted cardiovascular events. To examine these questions, the authors cross-sectionally studied 33,391 individuals from the Copenhagen General Population Study and 9,319 individuals from the Copenhagen City Heart Study followed for 14 years. After statistical adjustment for albumin levels, only triglyceride and apolipoprotein B concentrations were increased, and HDL cholesterol levels were reduced for up to 4-6 hours in response to normal food intake. The highest changes in lipid levels from fasting after normal food and fluid intake were -0.2 mmol/l for cholesterol, -0.2 mmol/l for LDL cholesterol, -0.1 mmol/l for HDL cholesterol, and +0.3 mmol/l for triglycerides. Comparing highest vs. lowest tertiles of nonfasting cholesterol, non-HDL cholesterol, LDL cholesterol, apolipoprotein B, triglycerides, cholesterol/HDL cholesterol ratio, and apolipoprotein B/apolipoprotein AI ratio or lowest vs. highest tertiles of HDL cholesterol and apolipoprotein AI significantly predicted an increased risk of cardiovascular events. These results cast doubt on the need for a fasting state before measuring the lipoprotein-lipid profile.
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