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 School of Medicine shows that this may not always be necessary.

“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, which was published online August 1 by the journal Pediatrics. “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.”

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 and UNC colleagues Asheley Cockrell Skinner, PhD, and Eliana Perrin, MD, MPH, studied a nationally representative sample of about 17,000 children and adolescents.

They 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 on 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.”