Impact of Fasting on triglycerides Poster For Hiv9 2008

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Impact of fasting bloods on hypertriglyceridemia. Nathan Billing, Mark Nelson & Graeme Moyle Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK. n [email_address] ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],If the Division of AIDS table for grading the severity of Adult and Paediatric adverse events (2004) 5 is used there would be a greater degree of Grade III and Grade IV complications with non-fasted levels The mean time of eating before phlebotomy was 20 minutes and for those that had something to drink only 17 minutes. Most of the patients undergoing phlebotomy were having lipid levels measured and a large number of patients were having these bloods on the day they saw their doctor. However only 8% reported having been informed that they needed to have these measurements whilst fasted. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Table 3: Division of AIDS table for grading the severity of Adult and Paediatric adverse events(2004) 5 Discussion: The difference between fasted and non fasted levels were higher than in other studies conducted. Craig Et al (2000) 6 conducted a study of the difference between non fasted blood samples and those taken after a 12 hour fast in 180 HIV negative patients. A statistically significant difference in total cholesterol level but not in HDL cholesterol levels was observed. Although the difference in these levels was not as marked as in this study a 1.8% reduction in total cholesterol and a 1.5% increase in HDL levels when bloods were fasted was found. Iin a cross sectional study by Bachorick et al (1991) 7 ,conducted in 154 untested HIV negative adults, fasting levels resulted in a reduction in cholesterol, triglyceride levels and HDL cholesterol level of -5.4%, -9.8% and -40% respectively. ,[object Object],[object Object],[object Object],Acknowledgement: Attendance to this conference was made possible by Sponsorship from Bristol-Myers Squibb, GlaxoSmithKline and Gilead Sciences 0 2 4 6 8 10 12 14 Ungraded Grade I Grade II Grade III Routine Bloods Fasted 0 5 10 15 20 25 30 35 Ungraded Grade II Grade III Grade IV Routine Bloods Fasted ,[object Object],[object Object],[object Object],Table 1: Changes in routine serum lipids when fasted Graph 2b: Change to DAIDS Triglyceride grading with fasted levels Both there results were statistically significant at a confidence interval of 95% as can be seen below in Graph 1. Graph 2A: Change to DAIDS Cholesterol grading with fasted levels Graph1: Percentage change in blood Lipids (CI at 95%) -60.0% -50.0% -40.0% -30.0% -20.0% -10.0% 0.0% TC:HDL ratio Triglyceride Biochemical marker n of Group Mean routine lipid levels (mmol/l) Mean percentage reduction with fasted bloods (%) 95% CI (%) Cholesterol 34 6.04(±1.2) -4.6 -10.27 , 1.00 TC: HDL ratio 11 7.11(±1.92) -35.4 -56.27 , -14.57 Triglyceride level 34 5.29(±2.9) -29.5 -41.33 , -17.64 DAIDS Grade Cholesterol Level Triglyceride level Grade I 5.18-6.19mmol/L ---- Grade II 6.2 -7.77mmol/L 5.65-8.48mmol/L Grade III >7.77mmol/L 8.49-13.56mmol/L Grade IV --- >13.56mmol/L

Impact of Fasting on triglycerides Poster For Hiv9 2008

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Impact of Fasting on triglycerides Poster For Hiv9 2008