Recomendaciones para el tamizaje, diagnóstico y monitoreo del perfil de lípidos: condiciones de fase preanalítica, ayuno y el rol del laboratorio clínico.

Abstract

Objective: To synthesize recommendations for screening, diagnosis, and monitoring of the lipid profile, with emphasis on preanalytical conditions and the use of non-fasting samples.

Methods: Review of EAS/EFLM consensus statements and evidence on the clinical–analytical performance of lipids in the postprandial state.

Results: The non-fasting profile reflects real-world lipoprotein exposure for most of the day, improves cardiovascular risk prediction, and facilitates patient compliance. LDL-C, whether measured directly or estimated, varies minimally without fasting; no clinically relevant changes are observed in HDL-C, apoB, or Lp(a). Postprandial triglycerides are a robust marker with stronger association to coronary disease. Derived metrics such as non-HDL-C and remnant cholesterol are recommended. Exceptions requiring 8-h fasting include TG >440 mg/dL, diagnostic glucose testing, fasting-sensitive hormones, and specific technical circumstances.