Triglyceride measurement and its relationship to heart disease

Elevated triglycerides are clinically important owing to their direct relationship to pancreatitis, and their association with glucose intolerance, and renal and hepatic disease. Their direct role in atherosclerosis is still controversial and their inter-relationships with other lipoproteins make clarity of this issue difficult. Triglyceride measurements, as part of lipid evaluation for atherosclerotic risk, are important as they provide the only convenient and cost-effective method for routinely estimating LDL cholesterol. Their inverse relationship to HDL makes triglyceride measurements a cost-effective screening procedure. Unlike cholesterol measurements, triglycerides should always be assessed in the fasting state. Analytical methods are predominantly based on enzymatic reagent systems that reliably measure the glycerol component after fatty acid hydrolysis. Standardization (that is, accuracy) is still a major problem, while precision appears satisfactory in most clinical laboratories.