In a routine lab for a healthy 10-year-old, a nonfasting specimen shows elevated triglycerides and total cholesterol. What is the most probable explanation?

In a routine lab for a healthy 10-year-old, a nonfasting specimen shows elevated triglycerides and total cholesterol. What is the most probable explanation?

• A. At risk for coronary artery disease
• B. Has type 1 diabetes mellitus that is undiagnosed
• C. Has an inherited genetic disease causing a lipid imbalance
• D. Was most likely not fasting when the specimen was drawn

Answer: (D)

Lipid levels, especially triglycerides, rise after eating because the gut releases chylomicrons that carry triglycerides into the bloodstream. In a nonfasting sample from a healthy child, this postprandial lipemia can elevate triglycerides and sometimes total cholesterol without indicating a disease. The most likely explanation is that the blood was drawn after a meal, not that the child has an inherited lipid disorder or a condition like coronary disease at this age. While persistent abnormalities could suggest an underlying lipid disorder, a single nonfasting result in a routine test in a healthy 10-year-old fits with recent food intake.

Lipid levels, especially triglycerides, rise after eating because the gut releases chylomicrons that carry triglycerides into the bloodstream. In a nonfasting sample from a healthy child, this postprandial lipemia can elevate triglycerides and sometimes total cholesterol without indicating a disease. The most likely explanation is that the blood was drawn after a meal, not that the child has an inherited lipid disorder or a condition like coronary disease at this age. While persistent abnormalities could suggest an underlying lipid disorder, a single nonfasting result in a routine test in a healthy 10-year-old fits with recent food intake.