Triglyceride to High-Density Lipoprotein ratio

1. 1. The TG/HDL ratio (Triglyceride to High-Density Lipoprotein ratio) is a valuable indicator for assessing cardiovascular risk.
   2. It compares the level of triglycerides (TG) to the level of HDL cholesterol (often referred to as “good” cholesterol).
   3. This ratio helps identify an individual’s risk for heart disease and metabolic issues, as both elevated triglycerides and low HDL cholesterol are associated with an increased risk of cardiovascular diseases.

Getting it done…

You will see the triglyceride and HDL results in the lab report.

1. 1. 1. I always ask my GP to include a lipids test whenever she/he mentions a blood test.  I usually ask for a lipids test and an HbA1c, even if they don’t!
         • The downside is that if you’re on a low-carb regime, the LDL results will indicate a high LDL, and you’ll be offered statins…check Dr Paul Mason’t lecture from the link in the references.
      2. It’s best if you are well fasted before the lipid test, or it’s not worth the sting of the needle prick. I always fast for at least 12 hours.  GPs and phlebotomists seem to have forgotten about this.

Normal and Risk Levels of TG/HDL Ratio:

In countries that use the “Système international d’unités” (SI units), like the UK, Australia, and NZ, the TG/HDL ratio is calculated from measurements in mmol/L. Americans and others use “mg/dl” (one-thousandth of a gram per one-tenth of a litre).

• • If mg/dl is your thing, The Blood Code is a good website, but note that ratios are not the same because the conversion constants for TG and HDL are different..  My thanks to colleague Prekure Health Coach Hannah Noble for the link. HERE

The typical interpretation of the TG/HDL ratio in mmol/L, based on available evidence, is as follows:

1. 1. Low Risk:
      • TG/HDL ratio ≤ 1.0
      • This is typically considered a healthy ratio. Individuals with a low TG/HDL ratio are generally at a lower risk for heart disease and metabolic syndrome.
   2. Moderate Risk:
      • TG/HDL ratio between 1.0 and 3.0
      • This range suggests moderate risk for cardiovascular problems. A ratio in this range may indicate the presence of factors like metabolic syndrome or early stages of insulin resistance.
   3. High Risk:
      • TG/HDL ratio ≥ 3.0
      • A ratio above 3.0 is often considered high and indicative of an increased risk for cardiovascular diseases, metabolic syndrome, and Type 2 diabetes. It is associated with a higher likelihood of lipid abnormalities and inflammation.

Clinical Importance:

• • Elevated Triglycerides and Low HDL cholesterol are linked to poor metabolic health, increasing the risk of atherosclerosis, heart disease, and stroke.
  • A high TG/HDL ratio is especially concerning because it indicates poor lipid balance, and it is often used alongside other indicators (like LDL cholesterol, blood pressure, and glucose levels) to assess overall cardiovascular risk.

Reference Ranges:

The exact thresholds can vary slightly depending on population characteristics and specific health guidelines, but the following general range is widely used:

• • TG/HDL ratio ≤ 1.0: Optimal
  • TG/HDL ratio 1.0 to 3.0: Average
  • TG/HDL ratio ≥ 3.0: High risk

• MS Excel TG/HDL calculator

Key References:

• • Krauss, R. M., “Triglyceride-to-HDL cholesterol ratio: A clinically useful measure of cardiovascular risk,” The American Journal of Cardiology, 2002.
  • Micha, R., et al., “Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes mellitus in 11 countries,” JAMA, 2017.
  • Mason, P.,  ‘Blood tests on a ketogenic diet – what your cholesterol results mean’, Low Carb Downunder lecture, 2018

These references highlight the relationship between lipid ratios and cardiovascular disease risk.

Waiver

This information is not intended to offer medical advice. Although I’ve done my best, I cannot guarantee its accuracy.  You use it at your own risk,