WASHINGTON — A calculation used every day in clinics throughout the world has just gotten an upgrade that eliminates the need for fasting to test cholesterol levels and provides better results.
“Rather than a one-size-fits-all approach, it’s now a more personalized estimate of LDL (low-density lipoprotein) cholesterol,” said Dr. Seth Martin of the Johns Hopkins University School of Medicine, who developed the new calculation for blood tests.
“This gives you better information to make decisions about heart disease management, cardiovascular prevention [and] about using treatments with solid evidence behind them to prevent heart attacks and strokes,” Martin said.
Eliminating the need to fast has advantages for both patients and the health care system.
“We see patients on the seventh floor, and the lab is on the main floor. They can go down and have it done on the way out,” Martin said.
The new method of calculating cholesterol levels also promises a smoother workflow in laboratories.
Laboratories typically see a large influx of people coming in for screenings first thing in the morning, since patients have to plan ahead to avoid food for 10 to 12 hours.
Quest Diagnostics is the first major lab in the U.S. to launch the non-fasting test.
“It replaces an outmoded approach to estimating levels of the bad cholesterol, LDL. Although that method has been the standard for 45 years, it is inaccurate and misleading in many cases, especially when the patient is not fasting,” said Jay Wohlgemuth, senior vice president of Quest Diagnosics.
That algorithm was created in 1972 by doctors at the National Institutes of Health. Martin said they used a data set of about 400 samples whereas he used more than a million.
“Certainly we have access to much better computing power here. We’re not having to sketch things out on a piece of paper,” Martin said.
Developing the new algorithm for calculating LDL-C was a several year process that began with Martin and colleague Steve Jones evaluating the problem, deciding how to approach it and then gathering and analyzing the data.
“I was very lucky to have a really talented group around me, motivating me, inspiring me, giving me guidance and feedback,” Martin said. “Once you spend many, many hours working on the problem you get to a more elegant, simple solution.”
Creating something that directly impacts the care of patients is a big deal, beyond just being able to publish the findings in a medical journal Martin said.
“It’s really gratifying to see it come this far.”