Triglyceride Elevation/ Low HDL in the Context of Normal LDL

[cdizzle55]

I am a 23 year old Male, 5'10 and 150 pounds. I recently had my cholesterol measured and was slightly surprised by my triglyceride levels as I eat a very healthy diet. My blood pressure has always been normal.

Total: 145
LDL: 84
HDL: 31
Triglycerides: 172
VLDL: 30

What is the meaning of these numbers in this context? I am aware that high Triglycerides/ Low HDL can mean insulin resistance and could also mean that ApoB is elevated even with low ldl. Does this warrant an ApoB or A1c measurement?

My doctor isn't concerned. I have a bit of a family history of heart disease so I would like to make sure I am covering my bases, especially since I am young and have time on my side.

[Red_Star]

High triglycerides and low HDL = small dense LDL. That’s a heart attack waiting to happen right there. Small dense LDL starts the plaque formation. Check out Sugar The Bitter Truth on YouTube. The information about LDL starts from 36:36.

[Sara_MHModerator]

Hello and welcome to the forum. Thanks for the question. Cholesterol is high from our lifestyle but also quite frequently by our simple genetics. Low HDL can be chronic even for someone who exercises due to genetics, for example. The issue seen here seems to be borderline high Triglycerides.  A reading of 172 is considered borderline. Something to watch. Perhaps something to work on although your doctor is not worried it seems. This is a nice article that talks about triglycerides and why they matter if elevated. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186.  However, they are only considered high if above 200. Do you consume alcohol? That is one of the main culprits for oddly raised triglycerides when other things are within normal.

[V_Drake]

Your borderline high TGs are likely to be a spurious lab result or from previous night’s cocktail. Mine ping-pong between ideal and 175 (borderline) based on carb/alcohol consumption the day before fasting blood tests.. Considering family history, I would absolutely have a coronary artery calcium (CAC) test done. And consider starting a low-dose statin even with your enviable numbers if your CAC score is >0.