Triglycerides

What is Triglycerides?

Triglycerides are the fats that circulate in your blood as an energy source. They respond strongly to what you've recently eaten and drunk. Raised triglycerides are often linked to your blood sugar and insulin regulation. Keeping them lower supports your heart and your metabolism.

Clinical frame

Raised triglycerides are a criterion of the metabolic syndrome and at the same time a mirror of insulin resistance: more free fatty acids flowing to the liver and hyperinsulinaemia drive up VLDL production, while the clearance of triglyceride-rich particles falls. This produces the typical pattern of high triglycerides, low HDL and small dense LDL particles ^[1].

It is not the triglycerides themselves but the triglyceride-rich lipoproteins and their remnant particles that are atherogenic: they penetrate the vessel wall and feed foam-cell formation and inflammation. Triglycerides are an indirect measure of that. ApoB, non-HDL or remnant cholesterol captures that atherogenic burden better, especially in insulin resistance ^[2].

Triglycerides are the only routine parameter that rises sharply after a meal, and they vary biologically a great deal. Screening can be non-fasting, but raised values or metabolic dysregulation call for a fasting re-measurement, and because of the variability a repeat measurement before clinical decisions ^[3].

What moves this value?

Lots of fast sugars, alcohol, little movement and excess weight can push this up. A recent meal counts too.

Less sugar and alcohol, more movement and weight loss often make this fall surprisingly quickly. Make sure you measure while fasting for an honest picture.

What this connects

• ApoB
• Glucose
• HbA1c
• HDL cholesterol

References

1. Mechanick, J. I., Farkouh, M. E., Newman, J. D. & Garvey, W. T. Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers: JACC State-of-the-Art Review. J Am Coll Cardiol 75, 525–538 (2020). doi.org/10.1016/j.jacc.2019.11.044
2. Peng, X. & Wu, H. Inflammatory Links Between Hypertriglyceridemia and Atherogenesis. Curr Atheroscler Rep 24, 297–306 (2022). doi.org/10.1007/s11883-022-01006-w
3. Wilson, P. W. F. et al. Lipid measurements in the management of cardiovascular diseases: Practical recommendations a scientific statement from the National Lipid Association writing group. J Clin Lipidol 15, 629–648 (2021). doi.org/10.1016/j.jacl.2021.09.046