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How High TG:HDL Impacts Heart Disease In Pre-Diabetes

Dr. Anthony Close
September 1, 2021
Health Hub

While it is common to look at blood glucose levels when testing for diabetes or prediabetes, knowing your HDL cholesterol levels in relation to your triglyceride numbers (TG:HDL) can give a better picture of your overall risk for diabetes as well as heart disease. 

That’s why it is so important to monitor your complete liver and cardiovascular health with more comprehensive blood tests. 

But what does it mean when you are pre-diabetic and have a high TG:HDL ratio? 

The latest research indicates that knowing your TG:HDL ratio could be a better predictor of heart disease. An elevated triglyceride to HDL cholesterol ratio is also an indicator of insulin resistance. Comprehensive testing to get a more complete lipid profile is more important than testing your cholesterol levels or LDL to HDL ratios alone. 

What is TG:HDL ratio? 

Your TG:HDL ratio can be determined by testing for both your triglyceride levels and your HDL cholesterol. The triglyceride to HDL ratio is then calculated by dividing your triglyceride level by your HDL number. 

Your TG:HDL ratio is a good predictor of both your risk for a heart attack as well as your risk for pre-diabetes or diabetes. 

Understanding your TG:HDL ratio and your risk profile

An ideal TG:HDL ratio is below 2. A high TG:HDL ratio of 3.75 and above could indicate insulin resistance and a relatively high risk of becoming pre-diabetic or developing type 2 diabetes. A high ratio also indicates you have a more dangerous small and dense LDL cholesterol type which could mean having a higher risk of coronary heart disease or stroke. 

A lower ratio is a sign that the insulin in your body is doing a good job of moving glucose and amino acids from your blood into your cells. 

When finding your TG:HDL ratio, you first need to test your triglyceride levels. A healthy triglyceride level is below 150 mg/dl. When blood sugar levels get too high, the extra sugar is converted into triglycerides by the liver. A higher level of these fats in your liver is an early sign of diabetes. 

Then you need to check your HDL cholesterol level. HDL cholesterol or high-density lipoproteins carry triglycerides away from your arteries to your liver where they can be broken down. When your HDL Cholesterol is too low, the level of fat in your bloodstream remains too high which can cause clots and heart attacks. A low HDL cholesterol level is also an early indicator of diabetes. A healthy HDL Cholesterol level should be above 40. 

TG:HDL Diabetes Prediabetes

Why people with pre-diabetes to know their TG:HDL ratio

The association between lipid levels in the blood, specifically the ratio of triglycerides to HDL cholesterol can help predict the extent of coronary disease in people with pre-diabetes or diabetes. 

Because diabetes has a high correlation between lifestyle factors and risk for the disease, pre-diabetes can be controlled or minimized through changes in diet or behavior. Knowing your TG:HDL ratio and risk for diabetes and heart disease can help in making better health choices to reduce your risk for both.  

How can you check your TG:HDL ratio?

The best way to get your TG:HDL ratio is by completing a blood lipid panel test that looks at both your triglyceride levels and your HDL cholesterol levels. Once you have these numbers you can work out your TG:HDL ratio. 

With a triglyceride to HDL ratio of 3.75 and above, you are more likely to be prediabetic. Knowing your ratio, you can start to make the necessary changes to prevent not only full-blown diabetes but heart disease too. 

These changes can include:

  • Getting more exercise
  • Following a proper diet and losing weight if needed
  • Cutting down on sugar, processed and fried foods, and red meat
  • Eating more fresh, whole foods such as vegetables and fruits

Lab Me offers two comprehensive tests that will help your monitor and manage your risks for diabetes and heart disease. 

Their Baseline Health Test helps monitor your cardiovascular, liver, kidney health & more while their Executive Health Check is a comprehensive test that helps monitor for cardiovascular disease, liver performance, cortisol, stress, unhealthy inflammation, vitamin D and manage both diabetes or pre-diabetes.

Always discuss your results with your health practitioner before embarking on any health plan. 

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