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Triglycerides are a form of fat and a major source of energy for the body. Most triglycerides are stored in adipose tissue as glycerol, monoglycerides, and fatty acids, and the liver converts these to triglycerides. Following eating, increased levels of triglycerides are found in the blood. Triglycerides move via the blood from the gut to adipose tissue for storage. Most triglycerides are carried in the blood by lipoproteins. Of the total triglycerides, about 80% are in VLDLs and 15% in LDLs, which play an important role in metabolism as energy sources and transporters of dietary fat.
Normal ranges: see Table 16.80.
Elevated levels of triglycerides in the blood are associated with an increased risk of developing cardiovascular disease and arteriosclerosis.
Concentrations associated with certain disorders:
Less than 150 mg/dL not associated with any disease state
250–500 mg/dL associated with peripheral vascular disease; may be a marker for patients with genetic forms of hyperlipoproteinemias who need specific therapy
Greater than 500 mg/dL associated with high risk of pancreatitis
More than 1,000 mg/dL associated with hyperlipidemia, especially type I or type V; substantial risk of pancreatitis
Greater than 5,000 mg/dL associated with eruptive xanthoma, corneal arcus, lipemia retinalis, enlarged liver and spleen
Hyperlipoproteinemia types I, IIb, III, IV, and V
Glycogen storage disease (von Gierke disease)
Nephrosis, chronic renal disease
Liver disease, alcoholism
Factors that increase triglyceride levels include food and alcohol intake (should be 12-hour fast [24 hours for alcohol]); corticosteroids, protease inhibitors for HIV, beta blockers, and estrogens; pregnancy; acute illness; smoking; and obesity.
Factors that decrease triglyceride levels include exercise and weight loss.
Diurnal variation causes triglycerides to be lowest in the morning and highest around noon.
Serum for triglyceride and for calculating LDL-C should follow a 12-hour fast.