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Evaluation of risk factors in individuals with elevated cholesterol values
Since cholesterol and triglycerides can vary independently, measurement of both is more meaningful than the measurement of cholesterol only.
Triglycerides are esters of the trihydric alcohol glycerol with 3 long-chain fatty acids. They are partly synthesized in the liver and partly derived from the diet.
Increased plasma triglyceride levels are indicative of a metabolic abnormality and, along with elevated cholesterol, are considered a risk factor for atherosclerotic disease. Hyperlipidemia may be inherited or be associated with biliary obstruction, diabetes mellitus, nephrotic syndrome, renal failure, or metabolic disorders related to endocrinopathies. Increased triglycerides may also be medication-induced (eg, prednisone).
The National Lipid Association and the National Cholesterol Education Program (NCEP) have set the following guidelines for lipids (total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and Non HDL cholesterol) in adults ages 18 and up:
Normal: <150 mg/dL
Borderline high: 150-199 mg/dL
High: 200-499 mg/dL
Very high: > or =500 mg/dL
The Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents has set the following guidelines for lipids (total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and non-HDL cholesterol) in children ages 2 to 17:
Acceptable: <75 mg/dL
Borderline high: 75-99 mg/dL
High: > or =100 mg/dL
Acceptable: <90 mg/dL
Borderline high: 90-129 mg/dL
High: > or =130 mg/dL
In the presence of other coronary heart disease risk factors, both borderline-high (150-199 mg/dL) and high values (>200 mg/dL) require attention.
Triglyceride concentrations >1,000 mg/dL can lead to abdominal pain and may be life-threatening due to chylomicron-induced pancreatitis.
1. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by CA Burtis, ER Ashwood. St. Louis, MO: Elsevier Saunders, 2012
2. Rifai N, Warnick GR: Laboratory Measurements of Lipids, Lipoproteins and Apolipoproteins. AACC Press, Washington, DC, 1994
3. Jacobson TA, Ito MK, Maki KC, et al: National Lipid Association recommendations for patient-centered management of dyslipidemia: Part 1-executive summary. J Clin Lipidol 2014;8(5):473-488
4. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Pediatrics 2011;128;S213