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Lipids

Triglycerides (TG)

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This is the date the draft was written, not a medical review date.

Triglycerides are the main fat transport form in chylomicrons and VLDL. Elevation contributes to cardiovascular risk and, when marked, to the risk of acute pancreatitis.

Reference interval

Conventional (mg/dL)SI (mmol/L)
Adults< 150 (upper limit) mg/dL< 1.7 (upper limit) mmol/L

Specimen: Serum or plasma (fasting preferred) · Conventional × 0.0113 = SI

Causes of high values

Obesity, insulin resistance and diabetes, alcohol excess, hypothyroidism, nephrotic syndrome, chronic kidney disease, familial hypertriglyceridaemia, pregnancy and drugs (oestrogens, corticosteroids, some antipsychotics, retinoids).

Causes of low values

Malnutrition, malabsorption, hyperthyroidism, abetalipoproteinaemia and lipid-lowering treatment; usually not clinically significant.

Pre-analytical and method notes

Normal is conventionally below 150 mg/dL (1.7 mmol/L); non-fasting levels are acceptable for risk screening but fasting is preferred if non-fasting triglycerides exceed about 400 mg/dL (4.5 mmol/L). Values above about 500-1000 mg/dL (5.6-11.3 mmol/L) raise pancreatitis risk; cut-offs vary by guideline. The SI conversion factor for triglycerides (0.01129) differs from that of cholesterol.

References

  1. 2018 AHA/ACC Guideline on the Management of Blood Cholesterol. American Heart Association / American College of Cardiology (2018) — Tier 2 (guidelines / primary literature)
  2. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European Society of Cardiology / European Atherosclerosis Society (2019) — Tier 2 (guidelines / primary literature)
  3. Rifai N, Horvath AR, Wittwer CT. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Elsevier, 6th edition (2018) — Tier 3 (textbook)

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