{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:58:08Z","timestamp":1790611088909,"version":"4.1.0"},"reference-count":32,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"abstract":"\n Importance<\/jats:title>\n Fasting before blood collection is widely practiced to reduce preanalytical variability, yet whether fasting-related differences are clinically meaningful across a broad panel of routine analytes has not been systematically evaluated using clinical data.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate whether fasting duration is associated with routine laboratory test results and whether observed differences exceed established analytical performance specifications (APS).<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Retrospective single-center cross-sectional study using laboratory information system data collected between February 2021 and December 2023 from a single 670-bed secondary-care university hospital in the Seoul metropolitan area, Republic of Korea. All samples were drawn from outpatients at the institution\u2019s central phlebotomy unit. Participants were adult outpatients (\u226518 years) with documented fasting duration. Data were analyzed from January 1, 2024, to July 24, 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Fasting duration derived from the time elapsed between the patient\u2019s last meal and blood collection, categorized as less than 8 hours, 8 to 12 hours, and more than 12 hours.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Adjusted means across fasting groups were estimated using linear mixed-effects models with patient-level random intercepts, adjusting for age, sex, and department. Paired within-person analyses among repeatedly tested patients were performed to minimize between-patient confounding. Differences were compared with the European Federation of Clinical Chemistry and Laboratory Medicine biological variation\u2013based total allowable error. Postprandial trends within the subgroup fasting less than 8 hours were assessed at 30-minute intervals.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The final dataset comprised 9\u202f755\u202f547 test results from 101\u202f148 patients across 372 test items. Between-group comparisons identified APS-exceeding differences for 27 analytes. However, only 10 were confirmed in paired within-person analyses, suggesting confounding. Glucose (10.8%), triglycerides (20.1%), \u03b3-glutamyl transferase (14.8%), and lipase (36.4%) were higher with less than 8 hours fasting. No analyte exceeded APS between the 8- to 12-hour and more than 12-hour groups. Within the less than 8-hour subgroup, glucose and lactate decreased significantly with increasing fasting duration, whereas lipid concentrations showed no significant linear trend.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This cross-sectional study found that fasting duration was associated with differences exceeding analytical performance specifications for only a few analytes, mainly glucose, triglycerides, \u03b3-glutamyl transferase, and lipase. No estimable within-person difference between the 8- to 12-hour and more than 12-hour groups exceeded an available APS. These findings support analyte-specific rather than uniform fasting requirements.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamainternmed.2026.4718","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:30:23Z","timestamp":1790609423000},"source":"Crossref","is-referenced-by-count":0,"title":["Fasting Duration and Differences Across Routine Laboratory Tests"],"prefix":"10.1001","author":[{"given":"Sunghwan","family":"Shin","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"},{"name":"Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sollip","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"},{"name":"Institute of Digital Healthcare, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinae","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Jin","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuenyoul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Hanyang University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeonghyun","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Hyun","family":"Um","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Rae","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Hee","family":"Whang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"4","key":"ioi260055r1","doi-asserted-by":"publisher","first-page":"343","DOI":"10.3343\/alm.2025.0022","article-title":"Standards and practice guidelines for venous blood collection: consensus recommendations from the Korean Society for Laboratory Medicine.","volume":"45","author":"Chang","year":"2025","journal-title":"Ann Lab Med"},{"issue":"4","key":"ioi260055r2","doi-asserted-by":"publisher","first-page":"250","DOI":"10.3343\/alm.2012.32.4.250","article-title":"Influence of a regular, standardized meal on clinical chemistry analytes.","volume":"32","author":"Lima-Oliveira","year":"2012","journal-title":"Ann Lab Med"},{"issue":"2","key":"ioi260055r3","first-page":"94","article-title":"Influence of a light meal on routine haematological tests.","volume":"8","author":"Lippi","year":"2010","journal-title":"Blood Transfus"},{"issue":"10","key":"ioi260055r4","first-page":"895","article-title":"Break the fast? 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Some considerations from the perspective of the clinical laboratory.","volume":"55","author":"Lorenzo Lozano","year":"2017","journal-title":"Clin Chem Lab Med"},{"issue":"7","key":"ioi260055r6","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1093\/clinchem\/hvae046","article-title":"Worldwide increasing use of nonfasting rather than fasting lipid profiles.","volume":"70","author":"Langsted","year":"2024","journal-title":"Clin Chem"},{"issue":"25","key":"ioi260055r7","doi-asserted-by":"publisher","first-page":"1944","DOI":"10.1093\/eurheartj\/ehw152","article-title":"Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine.","volume":"37","author":"Nordestgaard","year":"2016","journal-title":"Eur Heart J"},{"issue":"45","key":"ioi260055r8","doi-asserted-by":"publisher","first-page":"E1317","DOI":"10.1503\/cmaj.180804","article-title":"Nonfasting lipid testing: the new standard for cardiovascular risk assessment.","volume":"190","author":"Darras","year":"2018","journal-title":"CMAJ"},{"issue":"2","key":"ioi260055r9","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1097\/MED.0000000000000615","article-title":"Assessing the dyslipidemias: to fast or not to fast?","volume":"28","author":"Farukhi","year":"2021","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"issue":"22","key":"ioi260055r10","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1001\/archinternmed.2012.3708","article-title":"Fasting time and lipid levels in a community-based population: a cross-sectional study.","volume":"172","author":"Sidhu","year":"2012","journal-title":"Arch Intern Med"},{"issue":"2","key":"ioi260055r11","doi-asserted-by":"publisher","first-page":"90","DOI":"10.47429\/lmo.2024.14.2.90","article-title":"Quality status of the preanalytical phase of clinical laboratories in Korea.","volume":"14","author":"Choi","year":"2024","journal-title":"Lab Med Online"},{"issue":"3","key":"ioi260055r12","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1001\/jama.298.3.309","article-title":"Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women.","volume":"298","author":"Bansal","year":"2007","journal-title":"JAMA"},{"key":"ioi260055r13","doi-asserted-by":"publisher","DOI":"10.1017\/jns.2021.73","article-title":"Fasting, non-fasting and postprandial triglycerides for screening cardiometabolic risk.","volume":"10","author":"Keirns","year":"2021","journal-title":"J Nutr Sci"},{"issue":"10","key":"ioi260055r14","doi-asserted-by":"publisher","first-page":"675","DOI":"10.46747\/cfp.6910675","article-title":"PEER simplified lipid guideline 2023 update: Prevention and management of cardiovascular disease in primary care.","volume":"69","author":"Kolber","year":"2023","journal-title":"Can Fam Physician"},{"issue":"1-2","key":"ioi260055r15","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.clinbiochem.2013.11.002","article-title":"Influence of diet and sample collection time on 77 laboratory tests on healthy adults.","volume":"47","author":"Plumelle","year":"2014","journal-title":"Clin Biochem"},{"issue":"4","key":"ioi260055r16","doi-asserted-by":"publisher","first-page":"620","DOI":"10.4158\/EP12358.OR","article-title":"Should food intake and circadian rhythm be considered when measuring serum calcitonin level?","volume":"19","author":"Zayed","year":"2013","journal-title":"Endocr Pract"},{"issue":"5","key":"ioi260055r17","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1080\/07315724.1991.10718172","article-title":"Serum concentrations of retinol and retinyl esters in adults in response to mixed vitamin A and carotenoid containing meals.","volume":"10","author":"Rasmussen","year":"1991","journal-title":"J Am Coll Nutr"},{"issue":"1","key":"ioi260055r18","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1093\/ajcn\/37.1.147","article-title":"Determination of vitamin A in blood. 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AKWC, Fernandez-Calle? P, Jonker? N, . The eflm biological variation database. Accessed July 6, 2026. https:\/\/biologicalvariation.eu\/?"}],"container-title":["JAMA Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/articlepdf\/2854601\/jamainternal_shin_2026_oi_260055_1790087526.49618.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:30:27Z","timestamp":1790609427000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2854601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":32,"URL":"https:\/\/doi.org\/10.1001\/jamainternmed.2026.4718","relation":{},"ISSN":["2168-6106"],"issn-type":[{"value":"2168-6106","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}