Jessen R H, Dass C J, Eckfeldt J H
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis 55455.
Clin Chem. 1990 Jul;36(7):1372-5.
Distributions of concentrations of free glycerol in clinical plasma obtained for triglyceride assay were compiled to determine the frequency with which increased concentrations of free glycerol posed a potential problem for clinical interpretation of triglyceride results. Clinical histories were studied in patients with increased concentrations of free glycerol to ascertain possible reasons for the increase and to assess the relative clinical importance of glycerol-blank-corrected triglyceride results. Significant increases in free glycerol were very uncommon, usually occurring in patients receiving glycerol-containing hyperalimentation fluids, those receiving heparin (which causes both in vivo and in vitro increases in free glycerol), or those critically ill. Free glycerol was never increased significantly in a large outpatient population. Monitoring lipid metabolism in critically ill patients, or measuring true triglyceride concentrations in patients receiving glycerol-containing fluids, may represent rare exceptions for which glycerol-blank correction is necessary for accurate clinical diagnosis and management. We conclude that there is insufficient justification for the routine expenditure of extra time and reagents to correct most analytical enzymatic triglyceride methods for free glycerol.
为了确定游离甘油浓度升高对甘油三酯检测结果临床解读造成潜在问题的频率，我们汇总了临床血浆中用于甘油三酯检测的游离甘油浓度分布情况。对游离甘油浓度升高的患者的临床病史进行了研究，以确定升高的可能原因，并评估甘油空白校正后的甘油三酯结果的相对临床重要性。游离甘油显著升高的情况非常罕见，通常发生在接受含甘油的胃肠外营养液的患者、接受肝素治疗的患者（肝素会导致体内和体外游离甘油升高）或重症患者中。在大量门诊患者中，游离甘油从未显著升高。对重症患者的脂质代谢进行监测，或对接受含甘油液体的患者测量真实的甘油三酯浓度，可能是极少数需要进行甘油空白校正以实现准确临床诊断和管理的例外情况。我们得出结论，对于大多数分析性酶法甘油三酯检测方法，常规花费额外时间和试剂来校正游离甘油，理由并不充分。
