Free tool

Triglyceride to HDL Ratio Calculator

Q: What is a good triglyceride to HDL ratio?

Under 2 (with both values in mg/dL) is the pattern seen in insulin-sensitive adults with mostly large LDL particles. Between 2 and 3 is intermediate, and 3 or above is where most studies place the likelihood of insulin resistance. There is no official diagnostic cut point; the ratio supports a fasting glucose, A1c or fasting insulin rather than replacing them.

Q: Why do the units change the ratio?

Triglycerides and HDL convert to mmol/L by different factors (88.6 and 38.7), so the same blood gives a ratio in mmol/L units that is about 0.44 times the mg/dL ratio. A cut point of 3 in mg/dL corresponds to roughly 1.3 in mmol/L — always check which units a threshold was written for.

Q: Does the ratio work for everyone?

It was derived mainly in white adults and performs poorly in Black adults, in whom triglycerides tend to be lower at the same degree of insulin resistance, so a low ratio is less reassuring there. Women also tend to have lower ratios, and some studies use 2.5 as their threshold. Medications that move triglycerides or HDL shift the ratio without changing insulin sensitivity.

The short answer

Divide fasting triglycerides by HDL cholesterol, both in mg/dL, and you get the TG:HDL ratio — a simple marker of insulin resistance and of the small, dense LDL pattern. Ratios under 2 are typical of insulin-sensitive adults; 3 or more is the threshold most studies use to flag likely insulin resistance, with a lower cut point in women and weaker validity in Black adults.

Inputs: Triglycerides · HDL (fasting)
Marker of: Insulin resistance · small LDL
Common cut point: ≥ 3 (mg/dL units)
Cost: Free

Triglycerides (fasting)

mg/dL

Fasting 9–12 h · Triglycerides range

HDL cholesterol

mg/dL

HDL Cholesterol range

Enter your values to calculate.

TG:HDL = triglycerides [mg/dL] ÷ HDL cholesterol [mg/dL] (the mmol/L-based ratio is about 0.44 × this value, so cut points differ by unit)

Educational — a derived index, not a diagnosis. Nothing you enter leaves your browser.

How the TG:HDL ratio is calculated

TG:HDL = triglycerides [mg/dL] ÷ HDL cholesterol [mg/dL] (the mmol/L-based ratio is about 0.44 × this value, so cut points differ by unit)

Worked example

Triglycerides (fasting) (mg/dL)	HDL cholesterol (mg/dL)	TG:HDL ratio
150	45	3.33

Same ratio in mmol/L units: 1.46 · Note: The bands below use mg/dL-based cut points

Falls in: Elevated.

How to read the result

TG:HDL ratio	Reads as	What it usually means
< 2	Low	A ratio under 2 (mg/dL units) is the pattern of insulin-sensitive metabolism: triglycerides low relative to HDL, with a predominance of large LDL particles. It is the usual result in lean, active adults.
2 – 3	Intermediate	Between 2 and 3 the ratio carries no strong signal on its own. Read it with fasting glucose or A1c, waist circumference and blood pressure — the metabolic syndrome criteria — and with the absolute triglyceride and HDL values.
3 – 4	Elevated	A ratio of 3 or more is the threshold most studies use to flag likely insulin resistance in adults of European ancestry (the cut point is lower, about 2.5, in women and poorly validated in Black adults). It also predicts the small, dense LDL pattern. A fasting insulin with glucose (HOMA-IR) or an A1c is the usual next step.
≥ 4	High	Ratios of 4 and above reflect high triglycerides with low HDL — the atherogenic dyslipidemia of insulin resistance, prediabetes and type 2 diabetes. Weight, refined carbohydrate, alcohol and inactivity drive it and are what reverse it; glucose handling and liver enzymes are worth checking.

Cut points reviewed by Youmna DiStefano, MD on 2026-10-12. Sources below.

Limits

The ratio is a marker, not a diagnosis of insulin resistance: it was derived in cohorts of mostly white adults and performs poorly in Black adults, in whom triglycerides tend to be lower at the same degree of insulin resistance. It requires a fasting sample. Cut points are for mg/dL values — a ratio computed from mmol/L is about 0.44 times as large and must be read against different thresholds. Medications that change triglycerides or HDL (fibrates, omega-3, estrogen, retinoids, beta-blockers) shift it without changing insulin sensitivity.

Sources

McLaughlin T, et al. Use of Metabolic Markers To Identify Overweight Individuals Who Are Insulin Resistant. Ann Intern Med 2003;139:802–809. doi.org/10.7326/0003-4819-139-10-200311180-00007
McLaughlin T, et al. Is There a Simple Way to Identify Insulin-Resistant Individuals at Increased Risk of Cardiovascular Disease? Am J Cardiol 2005;96:399–404. doi.org/10.1016/j.amjcard.2005.03.085
Salazar MR, et al. Relation Among the Plasma Triglyceride/High-Density Lipoprotein Cholesterol Concentration Ratio, Insulin Resistance, and Associated Cardio-Metabolic Risk Factors in Men and Women. Am J Cardiol 2012;109:1749–1753. doi.org/10.1016/j.amjcard.2012.02.016
Sumner AE, Cowie CC. Ethnic differences in the ability of triglyceride levels to identify insulin resistance. Atherosclerosis 2008;196:696–703. doi.org/10.1016/j.atherosclerosis.2006.12.018

Frequently asked questions

What is a good triglyceride to HDL ratio?

Under 2 (with both values in mg/dL) is the pattern seen in insulin-sensitive adults with mostly large LDL particles. Between 2 and 3 is intermediate, and 3 or above is where most studies place the likelihood of insulin resistance. There is no official diagnostic cut point; the ratio supports a fasting glucose, A1c or fasting insulin rather than replacing them.

Why do the units change the ratio?

Triglycerides and HDL convert to mmol/L by different factors (88.6 and 38.7), so the same blood gives a ratio in mmol/L units that is about 0.44 times the mg/dL ratio. A cut point of 3 in mg/dL corresponds to roughly 1.3 in mmol/L — always check which units a threshold was written for.

Does the ratio work for everyone?

It was derived mainly in white adults and performs poorly in Black adults, in whom triglycerides tend to be lower at the same degree of insulin resistance, so a low ratio is less reassuring there. Women also tend to have lower ratios, and some studies use 2.5 as their threshold. Medications that move triglycerides or HDL shift the ratio without changing insulin sensitivity.

Which biomarkers does this tool cover?

Which tests give you these numbers?

Physician-authorized, drawn at Quest, Labcorp or BioReference. Results in 1–3 business days for most tests.