Fasting may not be needed for children’s cholesterol tests

Physicians usually ask children to fast overnight before a cholesterol test. New research from the University of North Carolina at Chapel Hill shows that this may not always be necessary.

Asheley Cockrell Skinner, PhD, adjunct assistant professor of health policy and management at UNC Gillings School of Global Public Health, co-authored the study, published online Aug. 1 in the journal Pediatrics.

 

“Doctors are more frequently checking cholesterol in children, and cholesterol testing can be difficult for children and families,” said Michael J. Steiner, MD, lead author of the study. “First of all, forcing children to fast can be difficult, and secondly, to draw blood in a fasting state, most children will have to return for a second doctor visit which can be problematic for busy families.”Steiner is chief of general pediatrics and adolescent medicine in the UNC School of Medicine’s Department of Pediatrics and a Master of Public Health student in the public health school’s Public Health Leadership Program.

 

Studies in adults have shown that some parts of cholesterol testing can be performed without fasting. To see if the same holds true for youngsters, Steiner, Skinner and Eliana Perrin, MD, MPH, alumna of the UNC public health school and associate professor of pediatrics in the UNC School of Medicine, studied a nationally representative sample of about 17,000 children and adolescents.The team used data from the National Health and Nutrition Examination Survey (1999-2006), which include results of cholesterol testing on children ages 3 and older and whether they had fasted for eight hours or more. Researchers looked at whether total cholesterol (TC), high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides were related to whether the child had fasted.

Results showed that those who fasted for at least eight hours and those who did not fast had similar levels of TC and HDL (good) cholesterol, and that LDL (bad) cholesterol was only slightly higher when fasting. Triglycerides varied more, depending upon whether the child had fasted.

“These results suggest it might be acceptable to simply test children immediately during whatever clinical visit prompted the recommendation to test,” Skinner said. “Because the American Academy of Pediatrics recommends cholesterol screening for a large group of children, these findings could reduce the burden of such screening.”

 

 

 

UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.