serum triglycerides

At present, there are enzymatic and chemical methods for the determination of TG. The enzymatic method has a one-step end point method and a two-step end point method. The main advantage of the two-step end point method is that it can remove the interference of free glycerol. Determination of triglycerides is helpful in understanding lipid metabolism, liver function (the liver is one of the synthetic triglyceride organs), and the diagnosis of diseases caused by atherosclerosis. Triglycerides fluctuate widely, depending on age, gender, dietary structure and lifestyle. Triglycerides in the human body are mainly synthesized in liver and adipose tissue, and can also be synthesized from food through small intestinal mucosa. Triglycerides in serum are mainly found in very low density lipoprotein (VLDL) and chylomicrons (CM). Hypertriglyceridemia is one of the risk factors for cardiovascular disease. Clinically tested serum triglyceride concentrations are mainly used for hyperlipidemia, pancreatitis, liver and kidney disease, atherosclerosis and nutritional evaluation. Basic Information Specialist classification: cardiovascular examination classification: biochemical examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Rare. Normal value: Serum triglyceride: 0.90-1.00mmol/L Above normal: Hypertriglyceridemia also has two types of primary and secondary, including familial hypertriglyceremia and familial mixed hyperlipidemia. Secondary findings in diabetes, glycogen accumulation disease, thyroid dysfunction, nephrotic syndrome, pregnancy, oral contraceptives, alcohol abuse, etc. negative: Positive: Tips: Before the examination, the diet is light and alcohol is prohibited. Check for an empty stomach in the morning. Normal value Enzymatic method (one-step end point colorimetry): M (male): 24.0-160 mg/dL. F (female): 28-108 mg/dL. The US National Cholesterol Education Program's revised opinion on the boundaries of fasting TG levels (1993) is: TG normal <2.3 mmol/L (<200 mg/dl). The ratio of TG increase is 2.3 to 4.5 mmol/L (200 to 400 mg/dl). Hypertriglyceridemia > 4.5 mmol / L (> 400 mg / dl). The high risk of pancreatitis is >11.3mmol/L (>1000mg/dl). Clinical significance Hypertriglyceridemia also has two types of primary and secondary, including familial hypertriglyceremia and familial mixed hyperlipidemia. Secondary findings in diabetes, glycogen accumulation disease, thyroid dysfunction, nephrotic syndrome, pregnancy, oral contraceptives, alcohol abuse, etc., but difficult to distinguish between primary or secondary. Hypertension, cerebrovascular disease, coronary heart disease, diabetes, obesity and hyperlipoproteinemia often have familial agglomeration, which may have a causal relationship, but may also be only a concomitant phenomenon; for example, insulin and glucose metabolism abnormalities in diabetic patients There may be a secondary TG (or TC) increase, but there may be two genetic factors, diabetes and high TG. Patients with coronary heart disease have higher TG than the general population, but this patient's high LDL-C and low HDL-C are also common. It is generally believed that high TG alone is not an independent risk factor for coronary heart disease, and only pathologically significant when accompanied by high TC, high LDL-C, and low HDL-C. Hyperlipoproteinemia is usually divided into type I, IIa, IIb, III, IV, V, etc., except for type IIa, high TG1I type is extremely rare high CMemia, for two reasons, one is familial LPL deficiency, one is hereditary apoCII deficiency. 2 The most common type is IV, followed by type IIb. The latter has both TC and TG, ie mixed type hyperlipoproteinemia; type IV only increases TG, reflecting the increase of VLDL, but VL is also high when VLDL is high. Mildly elevated, so type IV and type IIb are sometimes difficult to distinguish, mainly based on LDL-C levels. Familial hypertriglyceremia belongs to type IV. Type 3III is also known as abnormal β-lipoproteinemia, and both TC and TG are high, and the ratio is close to 1:1 (in mg/dl), but there is no chylomicronemia. The diagnosis also relies on lipoprotein electrophoresis to show wide β-band; after ultracentrifugation of serum at a density of 1.006 g/ml, the top (VLDL) is electrophoretically analyzed to demonstrate the presence of floating β-lipoprotein or electrophoretic migration in the β-position of VLDL, chemistry. The analysis showed that VLDL-C/serum TG>0.3 or VLDL-C/VLDL-TG>0.35; apoE typing was mostly E2/E2 homozygote. 4V type is increased in both chylomicrons and VLDL, and TG has up to 10g/L or more. This condition can occur on the basis of the original familial hypertriglyceridemia. Secondary factors include diabetes, pregnancy, nephrotic syndrome, and giant Globulinemia, etc., easily cause pancreatitis. High results may be diseases: non-alcoholic fatty liver disease, nonalcoholic fatty liver disease, chylothorax considerations 1. At this stage, one-step enzymatic method and two-step enzymatic method are allowed to coexist, and a gradual transition to a unified two-step method is required. Before the unification method, the laboratory should report “de-FG value” or “no FG value” when reporting the TG measurement result, which will help the clinician to correctly judge the result. 2. The average serum TG concentration of normal people is about 0.11mmol/L (10mg/dl). For TG with large fluctuation range, the error caused by this is negligible, but the TG in this specimen is obviously increased, so that the effect is affected. Judgment of TG levels, such as diabetes, emotional stress, glycerol-containing drugs, intravenous nutrition, and glycerol contamination when taking blood samples. In addition, improper storage and handling of the specimen will result in hydrolysis of TG to produce TG. 3. Although there are not many specimens with high endogenous TG, in order to avoid possible errors, the recommendations in foreign literature can be used for reference: clinical laboratories should have reagents that can go to TG blanks, for use when necessary, physical examination and Outpatients may not have TG blanks, except for diabetes or other special clinics; TG>2.3mmol/L is best for TG blank correction. For some suspicious situations, such as high TG and serum opacity, the possibility of high TG should be ruled out. Inspection process Do not eat foods containing a lot of fat for two days before taking blood, and take blood in the morning on an empty stomach (12h). A small amount of TG will be hydrolyzed during the storage of the specimen, and glycerin will be released. It is generally recommended that the storage should not exceed 3 days at 4 °C. 1. One-step method: 10μl of serum, standard solution and distilled water are added to the measuring tube, standard tube and blank tube respectively, and 1.00ml of each enzyme reagent is used, and the absorbance (A) is measured by photometer after 10 minutes at 37 ° C. The color is at least 500 nm. Can be stable for 1h. Serum TG (mmol/L) = (measuring tube A / standard tube A) x standard solution TG concentration (mmol / L). 2, two-step method: the test tube, the standard tube and the blank tube are respectively added with serum, standard solution and distilled water 10μl, each application reagent I0.5ml, mixed, 37 ° C water bath for 5min, and then add the application reagent II0. 5ml, mix and drink in a 37 ° C water bath for 10 min, blank tube calibration, absorb absorbance (A) at a wavelength of 500 nm, calculate the same step. Not suitable for the crowd no. Adverse reactions and risks no.

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