Triglycerides

Triglycerides, which are combinations of three fatty acids and one glycerol molecule, are used in the body to provide energy for various metabolic processes, with excess amounts stored in adipose tissue. Fatty acids readily enter and leave the triglycerides of adipose tissue, providing raw materials needed for conversion to glucose (gluconeogenesis) or for direct combustion as an energy source. Although fatty acids originate in the diet, many also derive from unused glucose and amino acids that the liver and, to a smaller extent, the adipose tissue convert into storage energy.

Altered triglyceride levels are associated with a variety of disorders and also are affected by hormones and certain drugs, including alcohol (Table 5-12). Diets high in calories, fats, or carbohydrates will elevate serum triglyceride levels, which is considered a risk factor for atherosclerotic cardiovascular disease.

Reference Values ⬆ ⬇

	Conventional Units	SI Units
<2 yr	5-40 mg/dL	0.06-0.45 mmol/L
2-20 yr	10-140 mg/dL	0.11-1.58 mmol/L
20-40 yr Men	10-140 mg/dL	0.11-1.58 mmol/L
20-40 yr Women	10-150 mg/dL	0.11-1.68 mmol/L
40-60 yr Men	10-180 mg/dL	0.11-2.01 mmol/L
40-60 yr Women	10-190 mg/dL	0.11-2.21 mmol/L

Note: Values for serum triglycerides may vary according to the laboratory performing the test. In addition, values have been found to vary in relation to race, income level, level of physical activity, dietary habits, and geographic location as well as in relation to age and gender, as shown here.

Interfering Factors ⬆ ⬇

Failure to follow the usual diet for 2 weeks before the test may yield results that do not accurately reflect client status.
Ingestion of alcohol 24 hours before and food 12 hours before the test may falsely elevate levels.
Drugs known to alter triglyceride levels should not be ingested within 24 hours before the test unless the test is being conducted to evaluate such effects (see Table 5-12).

Indications ⬆ ⬇

As a component of a complete physical examination, especially for individuals over age 40 years or who are obese, or both, to estimate the degree of risk for atherosclerotic cardiovascular disease
Family history of hyperlipoproteinemia (hyperlipidemia)
Known or suspected disorders associated with altered triglyceride levels (see Table 5-12)
Monitoring of response to drugs known to alter triglyceride levels or lipid-lowering agents

Care Before Procedure ⬆ ⬇

Nursing Care Before the Procedure

General client preparation is the same as that for any procedure involving collection of a peripheral blood sample (see Appendix I).

For this test, the client should ingest a normal diet, so that no weight gain or loss will occur for 2 weeks before the study, and should abstain from alcohol for 24 hours and from food for 12 hours before the test.
Water is not restricted.
It is also recommended that drugs that may alter triglyceride levels be withheld for 24 hours before the test, although this practice should be confirmed with the person ordering the study.

Procedure ⬆ ⬇

A venipuncture is performed and the sample collected in a red-topped tube. The sample should be sent promptly to the laboratory.

Care After Procedure ⬆

Nursing Care After the Procedure

Care and assessment after the procedure are the same as for any study involving the collection of a peripheral blood sample.

Resume foods and any drugs withheld before the test.
Abnormal values: Note and report increased level. Assess in relation to cholesterol and lipoprotein electrophoresis. Instruct in low-fat diet and weight reduction caloric intake as appropriate.