Biomarkers · Lipids & Apolipoproteins

Serum Triglycerides

Lower values go with lower risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 6% higher risk of death. We found the same pattern in NHANES

Serum Triglycerides and risk of death

NHANES, our fit with 95% CIPublished curve

Published curve higher than the NHANES fitNHANES fit higher

Risk of death relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.

Risk of death per SD (NHANES)1.06×95% CI 1.02–1.10 · 23,340 adults, 3,455 deaths

Published risk of death1.20×high TG (>= 200 mg/dL) vs referent (90-149 mg/dL) (95% CI 1.04–1.38) · Meta-analysis of 61 prospective cohort studies; all-cause mortality analyses: 58,419 deaths in 330,566 participants

Value of the measurement+0.003gain in concordance within age bands; rank 53 of 56 · all tests

Serum Triglycerides across cohorts

0.750.80.911.1HR per SD (95% CI)

NHANES · United States, 20–8423,340 people · 3,455 deaths1.06 1.02–1.10

CRELES · Costa Rica, 60+2,502 people · 478 deaths0.86 0.75–0.99

CHARLS · China, 50+7,014 people · 1,076 deaths1.02 0.92–1.12

Risk-of-death ratio per standard deviation, adjusted for age and sex, within each cohort. Cohorts differ in age range, assay, measurement protocol and follow-up, and one SD is a different amount in each, so the comparison is of direction and rough size per SD, not per unit. Vertical line: no association.

Serum Triglycerides by age and sex

Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.

The percentiles as a table

Each row is one sex and age band: the values below which 5%, 25%, 50%, 75% and 95% of people fall (mg/dL), from the survey named in the row. Not a reference range or a target.
Sex	Age	5th	25th	Median	75th	95th	n	Cycle / source
All	20-39	32.0	52.0	77.0	119	240	700	NHANES 2017-2018
All	40-59	39.4	64.8	97.0	153	258	761	NHANES 2017-2018
All	60+	43.0	73.0	102	140	225	912	NHANES 2017-2018
All	all	38.0	61.0	91.0	137	240	2,373	NHANES 2017-2018
Men	20-39	37.2	56.0	82.9	124	267	327	NHANES 2017-2018
Men	40-59	45.0	67.0	102	174	320	362	NHANES 2017-2018
Men	60+	44.0	78.0	107	150	231	462	NHANES 2017-2018
Men	all	40.0	64.0	97.0	147	268	1,151	NHANES 2017-2018
Women	20-39	29.2	48.0	68.4	111	209	373	NHANES 2017-2018
Women	40-59	36.5	62.0	93.0	137	205	399	NHANES 2017-2018
Women	60+	41.0	71.1	97.9	135	199	450	NHANES 2017-2018
Women	all	36.0	57.0	86.0	128	208	1,222	NHANES 2017-2018

What studies found when this marker was changed

They describe what happened in those study groups, not a recommendation. See all catalogued interventions.

Measured changes in Serum Triglycerides, study by study

8 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Intervention	Reported effect	Evidence	Source
diet	Omega-3 EPA/DHA intake (prescription 4 g/d)	Prescription EPA+DHA 4 g/d reduces triglycerides by >=30% in very high triglycerides	clinical guideline	Skulas-Ray AC, et al. Omega-3 Fatty Acids for the Management of…
diet	Very-low-carbohydrate ketogenic diet (no more than 50 g carbohydrate/day) vs low-fat diet	Triglycerides -0.18 mmol/L (95% CI -0.27 to -0.08) vs low-fat diet at 12 months or more	meta-analysis	Bueno NB, et al. Br J Nutr. 2013;110:1178-1187.
diet	Very low carbohydrate/ketogenic diet (<=50 g carbohydrate or <=10% energy per day) for >=6 months in adults with prediabetes or type 2 diabetes	Triglycerides 0.28 mmol/L lower with VLC/KD than control (95% CI -0.44 to -0.11; p < .001)	meta-analysis	Parry-Strong A, et al. Diabetes Obes Metab. 2022. Very low carbohydrate…
diet	Higher dietary fibre intake (e.g. +15 g/day or to 35 g/day) without other lifestyle change in adults with prediabetes or type 1/type 2 diabetes	Higher fibre intake lowers triglycerides by 0.16 mmol/L (95% CI -0.23 to -0.09; 28 trials)	meta-analysis	Reynolds AN, Akerman AP, Mann J. PLoS Med. 2020.
exercise	Modest weight loss of 5 to <10% in overweight/obese adults with type 2 diabetes (Look AHEAD)	Weight loss of 5 to <10%: odds ratio 2.20 for a 40 mg/dL decrease in triglycerides at 1 year vs weight-stable participants	cohort	Wing RR, et al. Diabetes Care. 2011;34:1481-1486.
exercise	High-intensity interval training programmes in adults with overweight or obesity (network meta-analysis of 28 RCTs)	HIIT lowers serum triglycerides by 20.55 mg/dL (95% CI -37.20 to -3.91) and fasting glucose by 14.31 mg/dL	meta-analysis	Wang H, et al. Front Endocrinol (Lausanne). 2023. Comparative efficacy of…
pharmacologic	Icosapent ethyl (Purified EPA 4g/day)	Lowers triglyceride levels (effect size not reported); in statin-treated patients with triglycerides 135 to 499 mg/dL, primary ischemic end point hazard ratio 0.75 vs placebo	RCT	Bhatt DL, et al. N Engl J Med. 2019;380:11-22.
pharmacologic	Resmetirom 100 mg orally once daily for 24 weeks in adults with NAFLD/presumed NASH (MAESTRO-NAFLD-1)	Triglycerides -20.4% vs placebo at 24 weeks with 100 mg (-15.4% with 80 mg); P<0.0001	RCT	Harrison SA, et al. Nat Med. 2023. Resmetirom for nonalcoholic fatty liver…
supplement	Increased long-chain omega-3 (EPA/DHA) intake, mostly via capsules at 0.5 to >5 g/day, for 12-88 months	Increasing long-chain omega-3 reduces triglycerides by ~15% in a dose-dependent way (high-certainty evidence)	meta-analysis	Abdelhamid AS, et al. Cochrane Database Syst Rev. 2020. Omega-3 fatty acids for…

Things that worsen it

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Condition or exposure	Reported effect	Evidence	Source
clinical	Uncontrolled Type 2 Diabetes and severe insulin resistance	Uncontrolled DM among secondary causes most strongly associated with moderate-to-severe (500-879 mg/dl) and severe (≥ 880 mg/dl) hypertriglyceridemia	cross-sectional	Ortega E, et al. Severe hypertriglyceridemia prevalence at a primary care…
diet	Excess (hypercaloric) fructose intake	Hypercaloric fructose raised triglycerides by 0.26 mmol/L (95% CI: 0.11, 0.41); no effect when isocaloric	meta-analysis	Chiavaroli L, et al. Effect of Fructose on Established Lipid Targets: A…

Sources

Risk curve: Liu 2013 (PMID 24164719): all-cause RR 1.2 (1.04-1.38) high TG (>= 200 mg/dL) vs referent (90-149 mg/dL). Scaled to US values (NHANES).
Liu et al. Effects of blood triglycerides on cardiovascular and all-cause mortality: a systematic review and meta-analysis of 61 prospective studies. Lipids in health and disease. 2013;12:159.
NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.

Map Serum Triglycerides against another biomarker.

Map Serum Triglycerides against another marker