Triglycerides: The Metabolic Health Indicator
Triglycerides reflect how your body handles fat and carbohydrates. High levels signal metabolic dysfunction, insulin resistance, and increased cardiovascular risk—especially when measured non-fasting.
Reference: < 100 mg/dL (optimal), 100-149 mg/dL (normal), 150-199 mg/dL (borderline high), 200-499 mg/dL (high), 500+ mg/dL (very high) mg/dL
Key Takeaway
Triglycerides are like a metabolic diary—recording everything you've eaten recently. High levels indicate your body is struggling to process fats and carbohydratesMiller M, et al. 2011. The combination of high triglycerides + low HDL-C is a red flag for insulin resistance and metabolic syndromeAHA, 2021.
What are Triglycerides?
Triglycerides are the main form of fat stored in your body and transported in your blood. After eating, your body converts excess calories into triglycerides, which are stored in fat cells. Between meals, hormones release triglycerides for energy.
Think of triglycerides as your body's shipping containers for fat. When you eat more calories than you need, your body keeps producing more containers. Blood vessels get clogged with these fat-filled containers, especially after meals.
Why Triglycerides Matter
- Metabolic health marker: High levels = insulin resistanceSethi A, et al. 2022
- Postprandial inflammation: Fat particles after meals damage arteries
- Remnant cholesterol: Triglyceride-rich particles directly cause plaqueToth PP, et al. 2019
- Pancreatitis risk: Levels ＞ 500 mg/dL can inflame the pancreas
- Heart disease risk: Independent predictor even after adjusting for other factorsBansal S, et al. 2007
- Optimal (＜ 100 mg/dL): Associated with lowest metabolic and cardiovascular riskAHA, 2021
- Normal (100-149 mg/dL): Acceptable range
- Borderline High (150-199 mg/dL): Early warning of metabolic issues
- High (200-499 mg/dL): Increased risk, requires interventionMiller M, et al. 2011
- Very High (500+ mg/dL): Pancreatitis risk, aggressive treatment needed
The Triglyceride:HDL Ratio
This ratio may be a better marker of insulin resistance than either value aloneAHA, 2021:
Understanding Your Results (ratio)
Optimal metabolic function, low insulin resistance risk
Possible early insulin resistance, consider lifestyle changes
Strong predictor of metabolic syndrome and insulin resistance
Remnant Cholesterol: The Hidden Danger
When triglycerides are high, your liver produces more VLDL particles. As VLDL loses triglycerides, it becomes "remnant cholesterol"—small, dense particles that easily enter artery walls and cause plaqueToth PP, et al. 2019. High triglycerides = high remnants = high risk, even if LDL-C looks normal.
Factors That Raise Triglycerides
- Dietary: Sugar, refined carbs, alcohol, excess caloriesSethi A, et al. 2022
- Sedentary lifestyle: Reduced fat clearance
- Insulin resistance: Body can't properly process fat
- Medications: Beta-blockers, steroids, estrogen, some antidepressants
- Genetics: Familial hypertriglyceridemia
- Thyroid disorders: Hypothyroidism elevates triglycerides
When Triglycerides Are Very High (＞500 mg/dL)
This requires urgent attention due to pancreatitis riskSethi A, et al. 2022:
- Pancreatitis: Severe inflammation of the pancreas
- Symptoms: Severe abdominal pain, nausea, vomiting
- Treatment: Very low-fat diet, fibrates, omega-3s, possibly hospitalization
- Goal: Rapid reduction to ＜ 500 mg/dL
Related Testing
- HDL-C: Calculate TG:HDL ratio
- ApoB: Total atherogenic particle count
- HbA1c: Check for diabetes/prediabetes
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