Triglyceride to HDL ratio (Triglyceride/HDL)

Low Triglycerides is seen in low carbohydrate intake / calorie deficit.

Elevated Triglycerides is seen in insulin resistance and pre-diabetes.

High Triglycerides is seen in diabetes.

Metabolic pattern: insulin resistance, high triglycerides, excess adiposity, type 2 diabetes, and low physical activity commonly lower HDL-C, especially when triglycerides are elevated.

Lifestyle and inflammation: cigarette smoking, acute or chronic inflammation, severe illness, malnutrition or malabsorption, liver disease, kidney disease, and hyperthyroidism can reduce HDL-C or impair HDL function.

Medications and genetics: androgens, progestins, anabolic steroids, some beta blockers, thiazide diuretics, and rare disorders such as apoA-I deficiency or Tangier disease can cause very low values.

Genetics and alcohol: familial high HDL, CETP-related variants, and higher alcohol intake can raise HDL-C; very high HDL-C does not necessarily mean better HDL function.

Hormonal and inflammatory: hypothyroidism, menopause-related changes, chronic inflammation, infection, and some liver or biliary disorders can be associated with high or dysfunctional HDL.

Less common: endurance training, medications, or markedly elevated HDL-C above about 100 mg/dL should be interpreted with apoB, triglycerides, liver enzymes, thyroid status, and family history.