Triglyceride In Serum

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Contents 1 Reference-interval 2 Principle 3 Clinical-significance 4 Increases 5 Specimen 6 More General Terms 7 Additional Terms 8 References

Reference-interval

• Male & Female: 23 - 147 mg/dL
• optimal level: < 100 mg/dL [9]

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 as described by Spayd, et al.
  
• 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 and 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, fatty acid esters of glycerol, represent the major form of fat found in the body; their primary function is to store and provide cellular energy. The concentration of triglycerides in the plasma at any given time is a balance between the rates of entry & removal. Triglycerides concentrations in the plasma vary with age & gender. Moderate increases occur during growth and development. 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.
  
• 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)

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

• general chemistry test

Additional Terms

• hypertriglyceridemia
• triglyceride

References

1. Kodak Ektachem 700 Analyzer Operator's Manual, Kodak Clinical Products, Rochester, New York.
2. Kodak Ektachem Slide Package Inserts, Kodak Clinical Products Rochester, New York.
3. Kodak Ektachem Training Manual, Kodak Clinical Products, Rochester, New York.
4. Tietz, N. W.(ed): Textbook of Clinical Chemistry. Philadelphia, W. B. Saunders, p. 889, 1986.
5. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998.
6. Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 11.
7. Prescriber's Letter 9(5):28 2002
8. 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: [1]
9. Miller M et al. Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation 2011 May 24 ; 123:2292 PMID: [2]

triglyceride in serum