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Table 4

When to use non-fasting and fasting blood sampling to assess the plasma lipid profile

	Patients for lipid profile testing
Non-fasting	In most patients, including: Initial lipid profile testing in any patient For cardiovascular risk assessment Patients admitted with acute coronary syndrome^a In children If preferred by the patient In diabetic patients^b (due to hypoglycaemic risk) In the elderly Patients on stable drug therapy
Fasting	Can sometimes be required if: Non-fasting triglycerides >5 mmol/L (440 mg/dL) Known hypertriglyceridaemia followed in lipid clinic Recovering from hypertriglyceridaemic pancreatitis Starting medications that cause severe hypertriglyceridaemia Additional laboratory tests are requested that require fasting^c or morning samples (e.g. fasting glucose^c, therapeutic drug monitoring)

	Patients for lipid profile testing
Non-fasting	In most patients, including: Initial lipid profile testing in any patient For cardiovascular risk assessment Patients admitted with acute coronary syndrome^a In children If preferred by the patient In diabetic patients^b (due to hypoglycaemic risk) In the elderly Patients on stable drug therapy
Fasting	Can sometimes be required if: Non-fasting triglycerides >5 mmol/L (440 mg/dL) Known hypertriglyceridaemia followed in lipid clinic Recovering from hypertriglyceridaemic pancreatitis Starting medications that cause severe hypertriglyceridaemia Additional laboratory tests are requested that require fasting^c or morning samples (e.g. fasting glucose^c, therapeutic drug monitoring)

^aWill need repeated lipid profile testing later because acute coronary syndrome lowers lipid concentrations.

^bDiabetic hypertriglyceridaemia may be masked by fasting.

^cIn many countries, fasting blood sampling is restricted to very few analytes besides lipid profiles: one example is fasting glucose; however, in many countries, even fasting glucose measurement is being replaced by measurement of haemoglobin A1c without the need to fast.

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