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What is the relationship between triglycerides and glucose? How to raise HDL? Worrisome ranges?

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Practicing since : 2001
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I am confused about two issues. First, about the relationship between triglycerides and glucose/A1C and how a person could have basically normal fasting glucose levels but high triglycerides or vice versa. I thought high triglycerides were caused by the same factors as high glucose. And there are various ranges for the A1C. How worrisome is an A1C of 6.1% with fasting glucose of 117?
Secondly, what is a true method to raise HDL even if LDL is not overly high? Related to this are the various ranges that are worrisome for HDL size, HDL-P and similar variations on HDL and LDL relating to insuline resistance and CVD etc.
Thank you. I look forward to your reply.
Posted Thu, 26 Apr 2012 in Thyroid Problem and Hormonal Problems
Follow-up: What is the relationship between triglycerides and glucose? How to raise HDL? Worrisome ranges? 1 hour later
Here is the added information that I am having trouble understanding as to its overall significance or reason for concern related to percentiles, etc:
HDL-P 25th percentile at 27.1 (higher risk CVD)
LDL size at 20.9 (Large) at 26.6 percentile.
Large HDL-P at 1.3 (low insulin resistant).
HDL size 8.3 at small insulin resistant
LP-IR Score of 47 at 50th percentile.
LDL-P 1858 (borderline high).
Follow-up: What is the relationship between triglycerides and glucose? How to raise HDL? Worrisome ranges? 2 hours later
Would any of these elements have anything to do with my low number of 174 in testosterone? I assume not, since I know people with testosterone in the 300s who have worse problems of glucose or cholesterol.
Answered by Dr. V. Kumaravel 19 hours later

I do understand your concerns about cholesterol problem, glucose (FBS) and A1C.

It is preferable to have FBS less than 100. your value of 117 is slightly elevated in the prediabetes range, but since your A1c is 6.1, nothing to be worried.

A1c ranges between 5.7 to 6.5 signifies prediabetes. Value above 6.5 signifies diabetes. In diabetes it is preferable to have A1C less than 7. Again this depends on the age and other comorbidities of the patient.

Triglycerides can be elevated in diabetes, renal problem, drugs, as a genetic abnormality and many more. In Diabetes, Insulin resistance is responsible for elevated triglycerides and increased blood sugar.

Elevated FBS can signify prediabetes and having high triglycerides is well documented with a blood sugar of 117. it is also definitly possible to have high triglycerides with normal FBS when your triglycerides metabolism is deranged for variety of reasons.

The best method to increase HDL is excercise, Quiting smoking and drugs like Nicotinic acid. LDL is a bad cholesteral. small LDL are more bad than large LDL.The particle size of HDL is not vallidated in clinical practice, but HDL is supposed to be a good cholesteral and higher the value it is better.

Your testosterone of 174 may be low for your age of 55. Low testosterone (Hypogonadism) is a risk factor for glucose and cholesteral problems, but these problems can occur with any levels of testosterone as rightly said by you.

Hope I have answered all your queries. Do write back to me if you have further queries.

Above answer was peer-reviewed by
Follow-up: What is the relationship between triglycerides and glucose? How to raise HDL? Worrisome ranges? 1 hour later
Thank you very much for your reply. For clarification, I have read that A1C over 5 or 5.5% is a problem, but you suggest that even my 6.1 is OK even though it's above 5.7??
My own Triglyc. is only 115. Do I need to work to lower more the A1C?

About particle size of HDL/LDL, are you suggesting I can basically ignore it then?
Regarding the testosterone, I don't think I have any symptoms of low testosterone except for no morning erection, which may be OK at 55 years old.
One report gives me HDL of 41, and another 44. Is that reason for concern because it is not at the optimal level of 60? My LDLs are "large" to the right end of the spectrum towards the smaller end.

Follow-up: What is the relationship between triglycerides and glucose? How to raise HDL? Worrisome ranges? 1 minute later
Is it preferable in general at my age not to take any drugs to improve my testosterone, to get it up into the 300s or 400s?
Answered by Dr. V. Kumaravel 8 hours later

Thanks for your follow-up.

As per the latest recommendation from American Diabetic Association (ADA), A1c of less than 5.7 is normal.

Your A1c of 6.1 will fall in to category of increased risk of diabetes ,that is nothing but a prediabetes stage. No medication would be required, but you should do regular excercise, reduce weight (If you are overweight or obese) and should have a watch on your diet in discussion with your nutritional consultant.

Your TGL (Triglycerides) of 115 is normal and no intervention to reduce it further is required.

About your particle size: There are drugs like Gemfibrozil that can improve your LDL(Low density Lipo protein) particle size, but there are no concensus or guidelines to use these drugs purely to increase your particle size and i may not recommend them.It is a prescription drug which has to given by your physician. It is optimal to have a HDL (High Density Lipoprotein) of 60, but anything more than 40 should be acceptable.

About your testosterone: There is a entity called androgen deficeincy in aging male (ADAM). XXXXXXX is nothing but a counterpart of menopause in females. It is not necessary that everyone has to be treated. Your clinical examination and Questinoire with a scoring system helps decide whether you need treatment or not.

Wishing you good health.
Above answer was peer-reviewed by
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