Ratio Triglycerides (TGL) vs High Density Lipoprotein (HDL) is used in risk assessment. Which statement is correct?

• A. The higher the ratio, the better
• B. The lower the ratio, the better
• C. The ratio is not related to risk
• D. The ratio should be around 3:1 for optimal health

Answer: (B)

The ratio of triglycerides to HDL reflects the balance between pro-atherogenic triglyceride-rich lipoproteins and protective HDL. When triglycerides are high and HDL is low, there’s a greater presence of small, dense LDL particles and insulin resistance, both of which raise cardiovascular risk. A lower TG/HDL ratio indicates that triglycerides are not disproportionately high relative to HDL, which corresponds to a healthier lipid profile and lower risk. There isn’t a universal fixed “optimal” ratio like 3:1 for everyone, and the ratio is one marker among others used to assess risk, but higher values consistently align with higher risk.