Triglyceride / HDL Ratio
Your triglycerides divided by your HDL cholesterol. Researchers use it as a simple hint of insulin resistance, but there is no standard cutoff.
AI-verified against cited sources. Awaiting expert reviewAlso called TG/HDL, TG:HDL, TG/HDL-CLOINC 44733-4
Check your result
The usual range for TG/HDL Ratio depends on age. Add your age above to see where you stand.
Nothing you type here leaves your browser.
What it is
This ratio divides your triglycerides by your HDL ("good") cholesterol, both taken from a standard lipid panel. High triglycerides and low HDL tend to go together when the body responds less well to insulin, so the ratio is sometimes used as a quick hint of insulin resistance. It is not a diagnosis, and it is not part of any guideline. The number depends on the unit used: a ratio worked out from mg/dL values is about 2.3 times larger than one worked out from mmol/L values.
Why it matters
A higher ratio has been linked to more heart disease and earlier death in large groups of people, with or without diabetes. A 2026 review of 27 cohort studies found a hazard ratio of about 1.5 for cardiovascular events, although the certainty of the evidence ranged from very low to moderate. There is no standard cutoff, so your clinician is more likely to follow triglycerides, HDL, LDL, non-HDL cholesterol or blood sugar markers directly.
If it’s high
A higher ratio means your triglycerides are high compared with your HDL. It often goes along with extra weight around the middle, high blood sugar and insulin resistance, but eating before the test can also raise it. No official cutoff exists, so your clinician will read it with your other results.
Common causes
- Eating shortly before the blood draw, which raises triglycerides
- Insulin resistance, prediabetes or diabetes
- Extra body weight, especially around the middle
- Low physical activity
- Regular alcohol intake
- Some inherited lipid conditions
What can help
- Ask your clinician what is driving your triglycerides or HDL
- Ask whether a fasting repeat or blood sugar tests such as an A1c would help
- Ask about lifestyle steps linked to lower triglycerides and higher HDL, such as regular physical activity, a healthy weight and not smoking
How common is your level?
NHANES describes the US civilian, non-institutionalized population, not a 'healthy' reference group. People with disease, on medication, fasting or not (except fasting-subsample markers), smokers and so on are all included. A percentile says where a value sits among Americans of that sex and age, not whether it is normal.
Use the left and right arrow keys to read each age. Shift moves five years.
Reference data derived from CDC/NCHS National Health and Nutrition Examination Survey (NHANES), cycles 2015-2016, 2017-March 2020 (pre-pandemic), August 2021-August 2023. Analysis by bloodtesttracker.com; not endorsed by CDC, NCHS or HHS.
Explore TG/HDL Ratio by age and sex: every percentile as a table, with a download.
What can affect your result
- Fasting or non-fasting sample: triglycerides rise after meals
- The unit used: the mg/dL ratio is about 2.3 times the mmol/L ratio
- Sex and age: HDL tends to be higher in women
- Body weight, physical activity and alcohol
- Medicines that change triglycerides or HDL
- The ratio comes from two separately measured numbers, so an error in either one carries into it.
- Eating before the test raises triglycerides and therefore the ratio, so follow your lab's fasting instructions.
- The unit basis changes the number: a ratio worked out from mg/dL values is about 2.3 times larger than one worked out from mmol/L values, so never compare the two directly.
- Medicines and conditions that change triglycerides or HDL change the ratio.
Triglycerides can shift within days to weeks while HDL changes more slowly, so the ratio moves over weeks to months.
When to talk to a clinician
This ratio rarely needs urgent action on its own. Talk with your clinician if the triglycerides on the same report are flagged as very high. Call 911 or your local emergency number for chest pain, trouble breathing or fainting.
Questions you could ask
- Was my ratio worked out from mg/dL or mmol/L values?
- Is my ratio high because of my triglycerides, my HDL or both?
- Would a fasting repeat or a blood sugar test help me understand this?
- Which numbers do you use to track my heart and metabolic health?
Questions people ask
What is a good triglyceride to HDL ratio?
Lower is generally better, but no lab or guideline sets a standard cutoff. One research study used a mg/dL-based ratio of about 3.0 to flag insulin resistance in overweight adults without diabetes, and it was right about two times out of three. That is a research cut-point, not a diagnosis, and you should check which unit your own report used.
Why does my ratio look different from the one in an article?
The ratio depends on the unit. Worked out from mg/dL values it is about 2.3 times larger than worked out from mmol/L values. For example, triglycerides of 150 mg/dL with HDL of 50 mg/dL give 3.0, or about 1.3 when calculated from the same values in mmol/L.
Do I need to fast for this ratio?
Triglycerides rise after a meal, which raises the ratio. Follow the fasting instructions your lab or clinician gives you for your lipid panel.
Show the science and sources
Units
- 1 ratio (from mg/dL) = 1 ratio (from mg/dL)
- 1 ratio (from mg/dL) = 0.4366 ratio (from mmol/L)
Open the TG/HDL Ratio unit converter
For clinicians and researchers
TG/HDL-C is a calculated ratio of two lipid panel results. Because triglycerides and cholesterol have different molar masses, the molar ratio equals the mass (mg/dL) ratio times 38.67/88.57, about 0.437; to turn a molar ratio back into the mg/dL basis, multiply by about 2.29. In McLaughlin 2003 (258 non-diabetic overweight adults; insulin resistance defined as the top tertile of steady-state plasma glucose), the best TG/HDL-C cut-point was reported as 1.8 in SI units (3.0 in traditional units), with 64% sensitivity and 68% specificity, similar to ATP III metabolic syndrome criteria. Those two figures are not exact conversions of each other (3.0 on the mg/dL basis is about 1.3 on the mmol/L basis), so any published cutoff needs its unit basis checked. A 2026 meta-analysis of 27 cohorts (949,043 people) found a pooled hazard ratio of 1.53 with diabetes and 1.47 without for cardiovascular events, and 1.25 and 1.23 for all-cause mortality; associations with stroke and coronary heart disease were stronger with diabetes. The authors note that no standardized cut-off has been established and that studies used varying thresholds or stratification, with certainty of evidence from very low to moderate.
LOINC 44733-4 (primary), 55607-6. Specimen: calculated.
Sources
- Use of metabolic markers to identify overweight individuals who are insulin resistant, Annals of Internal Medicine (2003)
- The modifying effect of diabetes on the association between triglyceride to high-density lipoprotein cholesterol ratio and cardiovascular risk: a systematic review and meta-analysis, Frontiers in Cardiovascular Medicine (2026)
- Cholesterol (PubChem CID 5997), PubChem, National Library of Medicine
- Triolein (PubChem CID 5497163), PubChem, National Library of Medicine
AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.