Metabolic health
Triglyceride to HDL cholesterol ratio (TG/HDL)
TG:HDL ratio
Included in every MyHealthspan membership: Focus, Baseline, and Complete.
Compare membershipsTwo lipid results that hint at insulin resistance.
The TG/HDL ratio is calculated by dividing your triglyceride result by your HDL cholesterol. Research links a higher ratio with insulin resistance, when your body needs more insulin to keep blood sugar in check.
This ratio combines two routine cholesterol results.
Insulin resistance tends to push triglycerides up and HDL cholesterol down at the same time. Dividing one by the other combines both shifts into one number, using results already in your lipid panel.
The ratio is a supportive research marker. It isn't a standard diagnostic test, and there's no agreed cut-off. Studies find it works better in some groups than others, varying by sex and ethnicity. Units matter too: Canadian labs report in mmol/L, so ratios from US studies (in mg/dL) don't transfer directly.
Two familiar numbers combine into one view of insulin resistance.
Questions
What does a higher ratio mean?
A higher ratio may suggest insulin resistance, which is linked with higher risk of type 2 diabetes and heart disease. It's one input among many, and your clinician will read it with your glucose, HbA1c, waist, blood pressure, and other cholesterol results.
Does eating before the test affect it?
Yes. Triglycerides can rise for several hours after a meal, which raises the ratio. Follow the preparation instructions you're given for your blood draw, and mention when you last ate if your result looks higher than expected.
Can the ratio change?
Yes. Triglycerides respond fairly quickly to eating patterns, alcohol, and physical activity, while HDL usually changes more slowly. Tracking the ratio over time, alongside your other results, shows more than a single reading.