triglyceride in serum
Physiology
- triglycerides, fatty acid esters of glycerol, represent the major form of fat found in the body
- primary function is to store & provide cellular energy
- the concentration of triglycerides in the plasma at any given time is a balance between the rates of entry & removal
Reference interval
Principle
The Kodak Ektachem Clinical Chemistry Slide (TRIG) is a dry, multilayered analytical element coated on a clear polyester support. The analysis is based on an enzymatic method.
A 10 uL drop of sample is deposited on the slide & is evenly distributed by the spreading layer. The surfactant in the spreading layer aids in dissociating the triglycerides from lipoprotein complexes present in the sample. The triglyceride molecules are then hydrolyzed by lipase to yield glycerol & fatty acids. Glycerol diffuses through the scavenger layer to the reagent layer, where it is phosphorylated by glycerol kinase in the presence of adenosine triphosphate (ATP) & magnesium chloride. In the presence of L-a-glycerophosphate oxidase, L-a-glycerophosphate is then oxidized to dihydroxyacetone phosphate & hydrogen peroxide. The final reaction involves the oxidation of a triarylimidiazole leuco dye by hydrogen peroxide, catalyzed by peroxidase, to produce a dye.
The density of the dye formed is proportional to the triglycerides concentration present in the sample & is measured by reflectance spectrophotometry
Surfactant Lipoproteins --------------> Triglycerides + Proteins
Lipase Triglycerides + H2O -------------> Glycerol + Fatty Acids
Glycerol kinase
Glycerol + ATP --------------> L-a-Glycerophosphate + ADP
MgCl2
L-alpha
Glycerophosphate
Oxidase
L-a-Glycerophosphate + O2 --------------> Dihydroxyacetone + H2O2
Phosphate
Peroxidase H2O2 + Leuco Dye -----------> Dye + H2O
Clinical significance
- triglycerides concentrations in plasma vary with age & gender
- moderate increases occur during growth & development
- higher levels of post-prandial triglycerides are observed in older adults
- triglycerides are used for the evaluation hyperlipidemias
- high triglycerides may favor thrombogenesis.
- risks for coronary disease & ischemic stroke are not associated with serum triglyceride levels[8]. Also see Field study & ACCORD trial.
- serum triglycereides > 150 mg/dL in high-risk statin treated patients associated with increased cardiovascular risk[11]
- pharmacologic therapy should be considered for serum triglycerides > 500 mg/dL[9]
Increases
- hypothyroidism
- nephrotic syndrome
- glycogen storage disease
- diabetes mellitus
- acute pancreatitis (very high levels)
- higher levels of post-prandial triglycerides in elderly
Specimen
Patient Preparation: Patients should be fasting for at least 12, preferably 16, hours prior to drawing the specimen.
For serum preparation collect whole blood & allow to clot according to manufacturer's instructions. Specimens are collected in a red top vacutainer by venipuncture & should be separated immediately from the cells after collection.
Equipment must be soap-free & glycerol-free. Do not use collection tubes with glycerol-lubricated stoppers. Latex gloves may be coated with glycerol.
Minimum sample size 0.5 milliliter with an optimum size of 1.0 milliliters or larger.
More general terms
More specific terms
- triglyceride in chylomicrons in serum/plasma
- triglyceride in lipoprotein<a> in serum/plasma
- triglyceride in VLDL in serum
- triglyceridein HDL in serum/plasma
Additional terms
Component of
- lipid panel (fasting lipid panel, FLP)
- cholesterol VLDL/triglyceride in serum/plasma
- cholesterol/triglyceride in serum/plasma
- lipoprotein pre-beta/triglyceride in serum/plasma
- chronic kidney disease panel
- pancreatic panel
- enteral/parenteral nutrition management panel
- triglyceride/HDL cholesterol in serum/plasma
References
- ↑ Kodak Ektachem 700 Analyzer Operator's Manual, Kodak Clinical Products, Rochester, New York.
- ↑ Kodak Ektachem Slide Package Inserts, Kodak Clinical Products Rochester, New York.
- ↑ Kodak Ektachem Training Manual, Kodak Clinical Products, Rochester, New York.
- ↑ Tietz, N. W.(ed): Textbook of Clinical Chemistry. Philadelphia, W. B. Saunders, p. 889, 1986.
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998.
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 11.
- ↑ Prescriber's Letter 9(5):28 2002
- ↑ 8.0 8.1 Di Angelantonio E et al. for the Emerging Risk Factors Collaboration. Major lipids, apolipoproteins, and risk of vascular disease. JAMA 2009 Nov 11; 302:1993. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19903920
- ↑ 9.0 9.1 9.2 Miller M et al. Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation 2011 May 24 ; 123:2292 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21502576
- ↑ Triglycerides, Serum or Plasma Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0020040.jsp
Panel of 6 tests
Panel of 6 tests Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0020468.jsp
Panel of 7 tests Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0080503.jsp
Panel of 5 tests Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0080570.jsp - ↑ 11.0 11.1 Toth PP, Philip S, Hull M, Granowitz C. Association of elevated triglycerides with increased cardiovascular risk and direct costs in statin-treated patients. Mayo Clin Proc 2019 Sep; 94:1670 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31405751 Free Article https://www.mayoclinicproceedings.org/article/S0025-6196(19)30382-9/fulltext