Understanding and Treating Triglyceride Disorders

Triglycerides (TG), the so-called forgotten lipid, are so very important to both human life and unfortunately to atherogenesis. Of course the correct term is triacylglycerol. Three acyl groups (fatty acids) are attached to a glycerol molecule. Triglycerides are an archaic term, which we all keep using. Serum TG refers to all of the TG trafficked within all of the lipoproteins that exist in a deciliter of plasma. A physiologic TG level is 10-70 with a mean of 30 mg/dL. NCEP ATP-III stated that unless pathological conditions are present, the TG should be < 100 mg/dL. With respect to CV risk, they stated borderline risk is > 150 mg/dL, high risk > 200 mg/dL and very high risk > 500 mg/dL when pancreatitis enters the picture. There is no specific NCEP ATP-III TG goal of therapy but it is suggested that non-HDL-C be normalized in patients with high TG or high TG and low HDL-C. Persons with significant TG abnormalities can have a multitude of genetic perturbations and many but not all have coexisting insulin resistance. NCEP ATP-III states that anyone with a TG > 100 mg/dL likely overeats, does not exercise, smokes, has diabetes, renal or other metabolic diseases, is on certain drugs or if the TG is >200 mg/dL has genetic forces at play.