ARTICOLO ORIGINALE   

La Rivista Italiana della Medicina di Laboratorio 2024 Dec 03

DOI: 10.23736/S1825-859X.24.00268-8

Copyright © 2024 EDIZIONI MINERVA MEDICA

language: Italian

Is non-fasting before venous sampling advisable?

Brunetta PORCELLI ^{1, 2}, Emirena M. GARRAFA ^{3, 4}, Simona G. SIGNORINI ⁴, Maria C. DI MARTINO ⁵, Fabio FERRETTI ⁶, Lucia TERZUOLI ^{1, 2} ✉ a nome del GdS-QuEA

¹ UOC Laboratorio Patologia Clinica, Azienda Ospedaliera Universitaria Senese, Siena, Italia; ² Dipartimento di Biotecnologie Mediche, Università degli Studi di Siena, Siena, Italia; ³ Dipartimento di Medicina Molecolare e Traslazionale, Università degli Studi di Brescia, Brescia, Italia; ⁴ Laboratorio Analisi Chimico Cliniche, Spedali Civili di Brescia, Brescia, Italia; ⁵ UOC Patologia Clinica, Ospedale Santa Maria della Pietà, Nola, ASL Napoli 3 Sud, Napoli, Italia; ⁶ Dipartimento di Scienze Mediche, Chirurgiche e Neuroscienze, Università degli Studi di Siena, Siena, Italia

BACKGROUND: To guarantee the reliability of the laboratoty results analyzes it is not only important to have careful control of the analytical activity, but also necessary to intervene in the preanalytical phase, which is not directly controlled by the laboratory staff itself. The study group on Extra-Analytical Quality (QuEA) of the Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) with a view to the identification and control of extra-analytical variables, fundamental for the subsequent analytical data issued and for the correct clinical management of the patient, decided to evaluate, for some biochemical parameters requested more frequently, whether it was possible to propose non-fasting to prepare the patient for the blood sample, in order to understand whether or not these can negatively influence subsequent clinical decisions.
METHODS: Twenty-seven volunteers presumably healthy (52 women, mean age 41±15 years and 22 men, mean age 36±15 years) joined the study. The first blood sample was collected between 7:00 and 9:00 in the morning after a 12-hour fast, while the second was collected between 14:00 and 16:00 in the afternoon, after the volunteers had had a free meal for 2 hours.
RESULTS: The estimated changes in biomarker concentrations are generally small, for all, except TR, a maximum change of 3% is reached, but in most they are similar before and after food intake.
CONCLUSIONS: From our data it emerges that there are no significant differences in the values of the analytes analyzed, with the sole exception of triglycerides, which instead are significantly different. The variation of triglycerides in non-fasting has been known for some time and, in some situations, such as risk screening in cardiovascular diseases, it is even considered useful. Certainly, the condition of non-fasting should be reported and the results should be evaluated with this awareness. It could be hypothesized to evaluate different reference intervals for fasting and non-fasting patients. In fact, the measurements in the two conditions of fasting or not do not necessarily have to be mutually exclusive. Obviously, in everyday reality this different sampling condition will have to be evaluated together with clinicians, always with a view to guaranteeing a result that does not negatively influence patient safety.

KEY WORDS: Blood specimen collection; Fasting; Biomarkers