Serum (Fasting or non-fasting)
Triglyceride in the fasting state comes from the liver in VLDL particles and their smaller IDL products. When triglyceride metabolism is markedly impaired, chylomicrons can be present in the fasting state. If the fasting triglyceride is above 5 mmol/L, the specimen will appear cloudy due to raised VLDL and/or chylomicrons which rise to form a creamy layer on standing.
Familial combined hyperlipidaemia; familial hypertriglyceridaemia; type III (“remnant removal disease”) hyperlipoproteinaemia
Obesity, alcohol, diabetes, hypothyroidism, liver disease (particularly obstructive), nephrotic syndrome, pancreatitis, pregnancy, significant illness, drugs (oestrogens, oral contraceptives, beta blockers, corticosteroids, thiazides, retinoic acid, anti-viral agents, valproic acid).
A patient with a triglyceride above 10.0 mmol/L is at risk for acute pancreatitis and requires immediate restriction of dietary fat and alcohol, treatment of any other underlying cause such as diabetes, and addition of a triglyceride-lowering drug such as a fibrate if other measures fail.
With massive hypertriglyceridaemias, serum can have the appearance and consistency of cream. Often there is more than one aetiology, e.g. diabetes and alcohol.
Triglyceride levels can rise and fall very quickly. Above a level of 6.0 mmol/L, lipoprotein lipase clearance mechanisms are saturated which means that dietary fat can rapidly raise triglyceride to surprising levels.
Dietary restrictions may cause it to fall equally quickly.
Can be added on to an existing request up to 4 days following sample receipt