Alan Watson posts: Participants with the highest Triglycerides (TG) & lowest HDL (Q4) were 16 times more likely to have a heart attack than those with lowest TG/highest HDL (Q1). Why, then, do most MDs focus only on LDL levels that only weakly predicted risk?
Marion Holman replies: The only reason the Triglyceride:HDL ratio is a good predictor of CVD is because it is a surrogate marker for predicting Insulin Resistance. Insulin Resistance, Inflammation & Infection can induce an imbalance in glucose metabolism that generates chronic hyperglycemia, which in turn triggers oxidative stress and causes an inflammatory response that leads to cell damage. Insulin resistance can also alter systemic lipid metabolism which then leads to the development of dyslipidemia and the well-known lipid triad: HIGH levels of plasma Triglycerides, (2) LOW levels of HDL, and (3) the appearance of small dense LDL-C.