PNLIP and alkaline phosphatase measurement: The hydrolysisof TGs by pancreatic lipase and release of free fatty acids (FFAs) induce freeradical damage, which can directly injure cell membranes.10 Additionally, severe or very severe HTG along with high lipase levels (>3times the upper limit of normal) are associated with very high FFA levels and canfurther be complicated by systemic inflammation from AP, direct activation oftoll-like receptor 2 and toll-like receptor 4 by FFA, and directlipotoxicity.11,12