Triglyceride: the forgotten risk factor.

The relation of serum TG concentrations and risk for CHD has been an issue of great interest and controversy. Unlike analyses with LDL-C and HDL-C, for which very strong and consistent relations with CHD risk have been demonstrated in observational and interventional studies, those with TG are ambiguous. Thus, TG represents a clinical conundrum: should it be measured, what does it mean, and should it be treated if elevated? In the past, the lack of an independent effect led one authority to advise against measuring TG or taking the serum TG concentration into account when assessing CHD risk. Also, TG measurement was fraught with problems, such as the confounding effect of free glycerol. In recent years, both analytic methods and biostatistical analysis have improved, and this forgotten risk factor has arisen again.