Шинэ судалгаагаар цусны ерөнхий шинжилгээ өгөхөөс өмнө 8-12 цаг өлөн байх уламжлалт заавар нь ихэнх тохиолдолд шаардлагагүй болохыг тогтоожээ.
Сөүл хотын Asan Medical Center-ийн судлаач Сүн-Хван Шин тэргүүтэй баг 2021-2023 оны хооронд 101,000 гаруй өвчтөний 9.7 сая гаруй шинжилгээний үр дүнд дүн шинжилгээ хийжээ. Судлаачид өвчтөнүүдийг 8 цагаас бага, 8-12 цаг, 12-оос дээш цаг өлөн байсан гэсэн гурван бүлэгт хуваан харьцуулсан байна. Үр дүнд нь 121 төрлийн шинжилгээний үзүүлэлтээс ердөө 10-т нь л өлөн байх нь нөлөөлдөг болохыг тогтоожээ.
Тодруулбал, глюкоз, триглицерид, гамма-глутамил трансфераза болон липаза зэрэг үзүүлэлтүүд нь 8 цагаас бага хугацаанд өлөн байсан хүмүүст өндөр гарсан байна. Харин бусад олон төрлийн шинжилгээнд өлөн байх нь төдийлөн нөлөөлдөггүй нь судалгаагаар нотлогджээ. Энэхүү судалгааны дүгнэлт нь JAMA Internal Medicine сэтгүүлд нийтлэгдсэн юм.
Судлаачдын үзэж буйгаар, одоо мөрдөж буй хатуу чанд шаардлагыг өөрчилж, шинжилгээний төрөл бүрт тохирсон нарийн аргачлалыг нэвтрүүлэх шаардлагатай байна. Гэсэн хэдий ч энэхүү үр дүн нь эмчийн зөвлөгөөг дагахгүй байх эсвэл одоогийн мөрдөж буй журмыг шууд цуцлах үндэслэл болохгүй гэдгийг мэргэжилтнүүд анхааруулж байна.
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Fasting is a common requirement for many routine laboratory blood tests, with patients often instructed to avoid eating or drinking anything except water for 8 to 12 hours before their sample is taken.
According to a new study, however, this step may be unnecessary for a wide range of tests.
Aside from a few notable exceptions, the findings suggest many patients could eat and drink in the hours before their tests without throwing off the results.
These results alone may not yet warrant changing the pre-test fasting standard, nor do they mean you should disregard medical instructions to fast. But they do provide compelling evidence for re-evaluating the wisdom of default fasting before routine bloodwork.
“Our comprehensive analysis suggests that most routine blood tests are minimally affected by short-term fasting, and fasting beyond 12 hours was not associated with meaningful additional differences for any test examined,” the study’s authors write.
“These findings suggest that traditional rigid fasting requirements may warrant reconsideration in favor of a more nuanced, analyte-specific approach to pretest preparation.”
Those rigid fasting rules originally grew from concerns that patients’ diets might jeopardize clinical accuracy. Results of blood tests often provide the basis for important medical decisions, and some measurements really are significantly sensitive to variables that occur before the test, such as food intake.
To minimize this variability, clinicians began broadly instructing patients to fast for eight to 12 hours before blood sampling – “a practice that originated with lipid and glucose testing,” the researchers explain, “but is now applied by default to much broader test panels.”
Yet despite the prevalence of this practice, recommendations for optimal fasting duration remain inconsistent. Research suggests fasting helps with certain tests, but its value across a diverse panel of tests hasn’t been systematically studied with clinical data.
Research on pre-test fasting comes largely from lipid tests, while comparable data are limited for tests focused on metrics such as liver enzymes, pancreatic enzymes, hematologic indices, hormones, and vitamins, the authors note.
As such, fasting recommendations can vary from one lab to another.
Given the limitations of existing research on the subject – plus the burden fasting can impose on patients – the authors of the new study took a closer look at this clinical tradition.
Led by Sunghwan Shin, a laboratory medicine physician at the University of Ulsan’s Asan Medical Center in Seoul, the researchers conducted a retrospective cross-sectional study using lab data collected between 2021 and 2023 from a single 670-bed university hospital.
Study subjects were all adult outpatients with documented pre-bloodwork fasting durations, which the authors of the new study divided into three categories: less than eight hours, eight to 12 hours, or more than 12 hours.
Their final data set included over 9.7 million test results from more than 101,000 patients, which the researchers scoured for signs of fasting-related differences that exceed established analytical performance specifications (APS).
After performing between-group comparisons and within-person analyses, they found a link between fasting duration and APS-exceeding differences for just 10 of the 121 analytes targeted by the blood tests.
Fasting does seem to help for those few analytes –mainly glucose, triglycerides, gamma-glutamyl transferase, and lipase, all of which were higher in patients who fasted for less than eight hours.
For many of the other analytes, however, the findings suggest fasting for eight hours or more might be a needless burden.
“These findings support analyte-specific rather than uniform fasting requirements,” the authors write.
In an accompanying commentary, clinical biochemist Liv Tybjærg Nordestgaard of Copenhagen University Hospital and her colleagues note the study “provides strong support for accumulating evidence that fasting blood sampling is not necessary.”
The research has been published in JAMA Internal Medicine.
This article was fact-checked by Rebecca Dyer and edited by Rebecca Dyer. While we pride ourselves on our process, we are only human. If you spot a mistake, please let us know.
