Nonfasting Lipids, Lipoproteins, and Apolipoproteins in Individuals with and Without Diabetes: 58 434 Individuals from the Copenhagen General Population Study

Background: Whether lipid profiles should be collected from fasting or nonfasting individuals is controversial, particularly in the diabetic population. We examined the influence of normal food intake on lipid profiles in diabetic and nondiabetic individuals.

Methods: We assessed plasma concentrations of lipids, lipoproteins, apolipoproteins, and albumin as a function of time since the last meal in 58 434 individuals (participation rate 45%) from the general population, 2270 of whom had diabetes mellitus.

Results: Similar patterns in the measured constituents were observed in the diabetic and nondiabetic populations. Triglycerides remained increased for 6-7 h in both populations after the last meal, whereas LDL cholesterol and albumin but not apolipoprotein B were reduced in both populations up to 5 h after normal food intake; after adjustment for hemodilution on the basis of albumin concentrations, the LDL cholesterol reductions were no longer present. Maximum observed mean differences from fasting concentrations in diabetic patients were -0.6 mmol/L, 0 mmol/L, 0.2 mmol/L, and 0.08 g/L (8 mg/dL) for LDL cholesterol, HDL cholesterol, triglycerides, and apolipoprotein B, respectively, and, correspondingly, -0.3 mmol/L, 0 mmol/L, 0.2 mmol/L, and 0.03 g/L (3 mg/dL) in individuals without diabetes.

Conclusions: Triglycerides increased up to 0.2 mmol/L after normal food intake in individuals with and without diabetes, whereas the postprandial reductions in LDL cholesterol observed in both populations likely were caused by hemodilution due to fluid intake. No statistically significant differences in postprandial apolipoprotein B concentrations were found. These data may be useful for discussion during revisions of guidelines for lipid measurements in individuals with or without diabetes.