Table of Contents

Locator Record

Title: Triglycerides and LDL-Cholesterol (TRIGLY_F )
Contact Number: 1-866-441-NCHS
Years of Content: 2009 - 2010
First Published: December, 2011
Revised: NA
Access Constraints: None
Use Constraints: None
Geographic Coverage: National
Subject:Lipids, Cholesterol, Cardiovascular Disease
Record Source: NHANES 2009 - 2010
Survey Methodology: NHANES 2009 - 2010 is a stratified multistage probability sample of the civilian non-institutionalized population of the U.S.
Medium: NHANES Web site; SAS transport files

Component Description

The goals of this component are: 1) to monitor the prevalence and trends in major cardiovascular conditions and risk factors in the U.S.; and 2) to evaluate prevention and treatment programs targeting cardiovascular disease in the U.S.

The main element of the cardiovascular disease laboratory component in NHANES is blood lipid levels. Cardiovascular disease is the leading cause of death in the United States. The data will be used to monitor the status of hyperlipidemia and the success of the National Cholesterol Education Program.

Eligible Sample

Participants aged 12 years and older, who were examined in the morning (AM) session, were tested.

Description of Laboratory Methodology

Blood specimens were processed, stored, and shipped to University of Minnesota, Minneapolis, MN for analysis. Vials are stored under appropriate frozen (–20°C) conditions until they are shipped to University of Minnesota for testing.

Roche Modular P chemistry analyzer
Triglycerides

In this enzymatic method reagent 1 (glycerol blanking) is added first. Free glycerol is converted to glycerol-3-phosphate (G3P) by glycerol kinase. G3P is acted upon by glycerol phosphate oxidase to produce dihydroxyacetone phosphate and hydrogen peroxide. The hydrogen peroxide combines with 4-chlorophenol under the action of peroxidase to produce an oxidation product that that does not react with the colorometric component of reagent 2. After this initial reaction sequence is completed, the Mod P records a blank absorbance reading. Then reagent 2 is added. The second reaction is driven by the reagents from bottle 1, with lipase added in reagent 2 to convert triglycerides to glycerol, and 4-aminophenzone added to react with the hydrogen peroxide produced in the last reaction. The reaction is measured at 505 nm (secondary wavelength = 700 nm). This method is a two-reagent, endpoint reaction that is specific for triglycerides.

Triglycerides are fatty acid esters of glycerol that have three hydroxyl groups. Because they are insoluble in water, the triglycerides are transported with other more polar lipids. Elevated triglyceride measurements are associated with diabetes mellitus, pancreatitis, alcoholism, glycogen storage disease, hypothyroidism, nephrosis, pregnancy, use of oral contraceptives and gout. Triglyceride levels are decreased in hyperthyroidism, use of certain lipid-lowering drugs and malabsorption syndrome

There were no changes (from the previous 2 years of NHANES) to equipment, lab method and lab site.

Detailed instructions on specimen collection and processing can be found in the NHANES Laboratory/Medical Technologists Procedures Manual (LPM).

Data Processing and Editing

Read the General Documentation on Laboratory Data file for detailed data processing and editing protocols. The analytical methods are described in the Description of Laboratory Methodology section above.

Three calculated variables were created in this data file. The formulas for their creation follow:

LBDTRSI

The triglycerides value in mg/dL (LBXTR) was converted to mmol/L (LBDTRSI) by multiplying by 0.01129.

LBDLDL

Serum LDL-cholesterol levels were derived on examinees that were examined in the morning session only. The distribution of serum LDL-cholesterol should be estimated only on examinees aged 12 and above who fasted at least 8.5 hours or more but less than 24 hours in the morning session. LDL-cholesterol is calculated from measured values of total cholesterol, triglycerides, and HDL-cholesterol according to the Friedewald calculation:

    [LDL-cholesterol] = [total cholesterol] – [HDL-cholesterol] – [triglycerides/5]

where all values are expressed in mg/dL. The calculation is valid for triglycerides less than or equal to 400 mg/dL.

LBDLDLSI

The LDL-cholesterol in mg/dL (LBDLDL) was converted to mmol/L (LBDLDLSI) by multiplying by 0.02586.

Laboratory Quality Assurance and Monitoring

The NHANES quality control and quality assurance protocols (QA/QC) meet the 1988 Clinical Laboratory Improvement Act mandates. Detailed QA/QC instructions are discussed in the NHANES Laboratory/Medical Technologists Procedures Manual (LPM). Read the General Documentation on Laboratory Data file for detailed QA/QC protocols.

Analytic Notes

The analysis of NHANES laboratory data must be conducted with the key survey design and basic demographic variables. The Demographic file contains: Status Variables providing core information on the survey participant including examination status, Recoded Demographic Variables including age, gender, race etc., and Interview and Examination Sample Weight Variables and Survey Design Variables. The Questionnaire Data Files contain socio-economic data, health indicators, and other related information collected during household interviews. The Phlebotomy Examination file includes auxiliary information on duration of fasting, the time of day of the venipuncture, and the conditions precluding venipuncture. The Demographic, Questionnaire and Phlebotomy Examination files may be linked to the laboratory data file using the unique survey participant identifier SEQN.

In cases, where the result was below the limit of detection, the value for that variable is the detection limit divided by the square root of two.

LBXTR and LBXLDL
Serum levels were measured for examinees that were examined in the morning session only. The distribution of serum triglycerides should be estimated only on examinees aged 12 and above who fasted at least 8.5 hours or more but less than 24 hours.

The Laboratory TRIGLY_F data file contains laboratory test results for triglycerides (LBXTR), which uses the reference analytic method. The NHANES Lab 40 biochemistry profiles also include measurements of triglycerides. The Lab 40 variable name is LBXSTR. The appropriate variable to use from the TRIGLY_F data file is LBXTR.

 

Sampling Weights
The analyst should use the special sampling weights in this file to analyze triglycerides and LDL-cholesterol.

Please refer to the NHANES Analytic Guidelines  and the on-line NHANES Tutorial  for further details on the use of sample weights and other analytic issues.

References

Codebook and Frequencies

SEQN - Respondent sequence number

Variable Name:
SEQN
SAS Label:
Respondent sequence number
English Text:
Respondent sequence number.
Target:
Both males and females 12 YEARS - 150 YEARS

WTSAF2YR - Fasting Subsample 2 Year MEC Weight

Variable Name:
WTSAF2YR
SAS Label:
Fasting Subsample 2 Year MEC Weight
English Text:
Fasting Subsample 2 Year MEC Weight
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 337218.92 Range of Values 3581 3581
. Missing 0 3581

LBXTR - Triglyceride (mg/dL)

Variable Name:
LBXTR
SAS Label:
Triglyceride (mg/dL)
English Text:
Triglyceride (mg/dL)
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
18 to 2742 Range of Values 3357 3357
. Missing 224 3581

LBDTRSI - Triglyceride (mmol/L)

Variable Name:
LBDTRSI
SAS Label:
Triglyceride (mmol/L)
English Text:
Triglyceride (mmol/L)
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.203 to 30.957 Range of Values 3357 3357
. Missing 224 3581

LBDLDL - LDL-cholesterol (mg/dL)

Variable Name:
LBDLDL
SAS Label:
LDL-cholesterol (mg/dL)
English Text:
LDL-cholesterol (mg/dL)
English Instructions:
LBDLDL = ROUND(LBXTC-(LBXHDD+LBXTR/5) for LBXTR less than or equal to 400 mg/dL, and missing for LBXTR greater than 400 mg/dL
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
13 to 266 Range of Values 3308 3308
. Missing 273 3581

LBDLDLSI - LDL-cholesterol (mmol/L)

Variable Name:
LBDLDLSI
SAS Label:
LDL-cholesterol (mmol/L)
English Text:
LDL-cholesterol (mmol/L)
Target:
Both males and females 12 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0.336 to 6.879 Range of Values 3308 3308
. Missing 273 3581