Triglycerides/HDL ratio: The hidden biomarker that predicts how fast you're aging

There’s a number in your blood test results that your doctor probably never calculates — yet it predicts the risk of heart attack, diabetes, and accelerated aging better than many individual tests.

It’s not total cholesterol. It’s not LDL cholesterol. It’s the ratio between triglycerides and HDL cholesterol — a simple quotient you can calculate in 5 seconds with your latest lab results.

The research is impressive: people with the highest TG/HDL ratio have up to 16 times higher cardiovascular risk compared to those with the lowest ratio. And an elevated ratio is one of the earliest signals of insulin resistance — the hidden engine of accelerated aging.

The good news? This ratio is highly modifiable. In this article, we’ll explain how to calculate it, what the optimal values are for longevity, and 7 scientific strategies to improve it.

For lab-report reference pages with ranges, aliases, and SuperAge context, see the triglycerides biomarker guide and the HDL cholesterol biomarker guide.

What you’ll learn:

• What is the triglycerides/HDL ratio and how to calculate it
• Optimal values for longevity (men and women)
• Why it predicts aging better than total cholesterol
• The connection with insulin resistance and small, dense LDL particles
• What centenarians and Blue Zones teach us
• Beyond the heart: sarcopenia, cognitive decline, and metabolic syndrome
• 7 evidence-based strategies to optimize the ratio
• How SuperAge tracks triglycerides, HDL, and your biological age
• FAQ

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What is the triglycerides/HDL ratio?

The triglycerides/HDL (TG/HDL) ratio is simply the result of dividing your triglycerides value by your HDL cholesterol, both expressed in mg/dL.

Quick definition: The TG/HDL ratio is an index calculated by dividing triglycerides by HDL cholesterol. It’s considered one of the best indirect predictors of insulin resistance, LDL particle size, and overall cardiometabolic risk.

Formula:

TG/HDL Ratio = Triglycerides (mg/dL) ÷ HDL cholesterol (mg/dL)

Practical example:

• Triglycerides: 90 mg/dL
• HDL: 60 mg/dL
• Ratio: 90 ÷ 60 = 1.5 ✅ (excellent)

If instead you have:

• Triglycerides: 200 mg/dL
• HDL: 40 mg/dL
• Ratio: 200 ÷ 40 = 5.0 ⚠️ (very high)

Why it’s more useful than individual values

Triglycerides and HDL, taken individually, only tell part of the story. Triglycerides can be “normal” (under 150 mg/dL) but if your HDL is low, the ratio reveals a problematic metabolic profile that individual numbers hide.

The TG/HDL ratio integrates two crucial pieces of information into a single number:

• High triglycerides = the body is accumulating fats in the blood (often from excess sugars and refined carbohydrates)
• Low HDL = the cholesterol “cleanup” system from arteries is inefficient

When both go in the wrong direction — triglycerides up, HDL down — the ratio amplifies the warning signal.

If your specific pattern is high triglycerides but normal ApoB, read that result differently: ApoB is reassuring for particle count, while triglycerides still need fasting confirmation and metabolic context. See the focused guide to high triglycerides with normal ApoB.

Note on units of measurement: If your lab results report values in mmol/L (common in some European countries), the optimal ratio is different: divide the value in mmol/L to get the ratio, where < 0.87 is considered ideal. In this article we use mg/dL, the standard in the United States.

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Optimal values for longevity

Your doctor might tell you that triglycerides are “fine” if under 150 mg/dL and HDL is “good” if above 40 mg/dL. But longevity research indicates much more ambitious thresholds.

TG/HDL Ratio	Interpretation	Risk
< 1.0	Ideal — centenarian profile	Minimal
1.0 - 2.0	Good — good metabolic health	Low
2.0 - 3.0	Borderline — watch for insulin resistance	Moderate
3.0 - 4.0	High — likely insulin resistance	Elevated
> 4.0	Very high — metabolic syndrome probable	Very elevated

Differences between men and women

An often overlooked aspect: risk thresholds are different for men and women.

	Men	Women
Optimal	< 2.0	< 1.5
Metabolic syndrome risk	> 2.75	> 1.65
High risk	> 4.0	> 3.0

Women are metabolically more sensitive to this ratio. A value of 2.5 in a man might be “borderline,” but in a woman it already indicates significantly elevated risk of metabolic syndrome — a study published in the Journal of the American Heart Association confirmed this gender difference by analyzing data from over 14,000 adults.

How it changes with age

The TG/HDL ratio tends to worsen with age, especially after 40, due to:

• Reduced insulin sensitivity
• Decreased physical activity
• Hormonal changes (menopause in women, testosterone decline in men)
• Visceral fat accumulation

But it’s not inevitable. People who maintain active lifestyles and balanced nutrition can maintain excellent ratios even in advanced age — as demonstrated by Blue Zone centenarians.

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Why it predicts aging better than total cholesterol

Total cholesterol is the number everyone knows and that doctors routinely prescribe. But as a predictor of aging and mortality, it’s surprisingly weak — especially after 60, when “normal” or even low cholesterol can mask deep metabolic problems.

The TG/HDL ratio is superior for three fundamental reasons.

1. It’s the best indirect indicator of insulin resistance

Insulin resistance is considered by many researchers the central engine of accelerated aging. When cells become less sensitive to insulin, the pancreas produces more of it, and this excess triggers a cascade of damage:

• Chronic low-grade inflammation
• Oxidative stress
• Protein glycation (the same process measured by HbA1c)
• Visceral fat accumulation
• Mitochondrial dysfunction

A 2024 systematic review in Biomedicines evaluated 32 studies with 49,782 participants and found that the TG/HDL ratio can work as a simple, low-cost surrogate marker for insulin resistance. The important nuance: accuracy varies by sex, ethnicity, body composition, and the cutoff used. Average insulin-resistance cutoffs clustered around 2.5 for women and 2.8 for men, but the review emphasized that TG/HDL should be interpreted with patient context rather than treated as a standalone diagnosis.

In practice: if your fasting TG/HDL ratio is around or above 3.0, treat it as a strong reason to look deeper — fasting glucose, HbA1c, fasting insulin, waist circumference, blood pressure, ApoB, and non-HDL cholesterol all matter. Current dyslipidemia guidance still prioritizes LDL-C and non-HDL-C treatment goals, with ApoB especially useful when triglycerides are elevated, diabetes or metabolic syndrome is present, or LDL-C looks deceptively low. TG/HDL is a contextual risk signal, not the treatment target. A related and complementary marker is the Triglyceride-Glucose (TyG) index — a calculated biomarker derived from fasting triglycerides and glucose that captures both hepatic and peripheral insulin resistance and has demonstrated strong predictive value for cardiovascular events and metabolic syndrome.

2. It predicts LDL particle size

Not all LDL cholesterol is equal. There are large, “fluffy” LDL particles (pattern A) and small, dense LDL particles (pattern B). It’s the latter that are truly dangerous: they penetrate the arterial wall more easily and oxidize more rapidly, accelerating atherosclerosis.

One easy place to make a unit error: older diabetes research used a TG/HDL molar ratio above 1.33, which is roughly 3.0 when triglycerides and HDL are entered in mg/dL, to identify most patients with small LDL particles. Later work in broader populations used cutoffs closer to 3.8. The practical lesson is not that 1.33 is a universal mg/dL cutoff; it is that a clearly elevated ratio makes small, dense LDL more likely and should prompt a broader lipid-risk check.

TG/HDL Ratio	Predominant LDL particles
< 2.0	More often large, buoyant (pattern A) — better metabolic profile
2.0 - 3.0	Mixed zone — interpret with ApoB, non-HDL-C, glucose, and waist circumference
> 3.0 (especially > 3.8)	Small, dense LDL becomes more likely — more atherogenic profile

This means the TG/HDL ratio gives you information that would normally require an expensive lipoprotein subfraction test (NMR lipoprofile) — for free, with your standard lab tests.

3. It integrates metabolic and cardiovascular risk

The TG/HDL ratio isn’t just a cardiac marker. It’s a systemic indicator of metabolic health that correlates with:

• Insulin resistance
• Chronic inflammation (correlation with high-sensitivity CRP)
• Visceral fat
• Hepatic steatosis (fatty liver)
• Oxidative stress

All these factors are fundamental drivers of biological aging. An elevated TG/HDL ratio doesn’t just tell you that your heart is at risk — it tells you that your entire organism is aging faster than necessary.

A 2025 cohort study published in Scientific Reports on diabetic patients without known cardiovascular disease confirmed the predictive value in the highest-risk groups: the high TG/HDL-C group had a 89% higher risk of cardiovascular events compared with the low group (HR 1.89, 95% CI 1.45–2.47), reinforcing the ratio’s role as an early-warning marker even before clinical heart disease appears.

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What centenarians and Blue Zones teach us

If you want to understand what metabolically distinguishes people who live longer, the lipid profile of centenarians is illuminating.

The cholesterol paradox in Sardinia

Sardinia is one of the five Blue Zones in the world — areas with the highest concentration of centenarians. An aspect that surprised researchers is the so-called “cholesterol paradox”: many Sardinian centenarians have total cholesterol levels that would be considered “high” by conventional standards.

But when you look at the profile in detail, a clear pattern emerges:

• Elevated HDL — often above 60 mg/dL
• Low triglycerides — frequently under 100 mg/dL
• Excellent TG/HDL ratio — typically under 1.5

A study published in PMC in 2025 analyzed this paradox, concluding that it’s not total cholesterol that determines longevity, but the qualitative lipid profile — and the TG/HDL ratio is its best summary.

HDL and exceptional longevity

A fundamental study published in The Journals of Gerontology demonstrated that elevated HDL levels are associated with exceptional longevity (survival beyond 95 years), independent of other risk factors. Centenarians in the Ashkenazi study had significantly higher HDL levels and larger, more functional HDL particles compared to controls.

The ideal lipid profile for longevity

Based on data from centenarians and long-lived populations, the “centenarian” lipid profile is:

Parameter	Target value
Triglycerides	< 100 mg/dL
HDL cholesterol	> 60 mg/dL (men), > 70 mg/dL (women)
TG/HDL ratio	< 1.5 (ideally < 1.0)
ApoB/ApoA1	< 0.7

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Beyond the heart: what the TG/HDL ratio reveals

The TG/HDL ratio isn’t just a cardiovascular marker. Recent research has greatly expanded its clinical significance.

Sarcopenia and muscle loss: a nuanced picture

The relationship between TG/HDL ratio and sarcopenia (age-related loss of muscle mass and strength) is more complex than for other endpoints. In middle-aged adults, insulin resistance signaled by an elevated TG/HDL ratio plausibly compromises muscle protein synthesis and promotes a catabolic state — exactly the processes that drive sarcopenia.

But in the elderly, the picture inverts. A 2026 study in Scientific Reports analyzing 2,481 participants aged 60+ from the China Health and Retirement Longitudinal Study (CHARLS) found that higher TG/HDL-C quartiles were actually protective against incident sarcopenia over 4 years of follow-up (OR 0.34 for Q3 and OR 0.55 for Q4 versus the lowest quartile). This mirrors the broader “lipid paradox” of aging: in late life, very low triglycerides or HDL can reflect under-nutrition, chronic disease, or frailty rather than metabolic health.

Practical implication: before 60, work to keep your TG/HDL ratio low — it protects against the insulin resistance that drives muscle loss. After 60, the priority shifts toward maintaining adequate nutrition, protein intake, and resistance training; a very low ratio alongside unintended weight loss is a flag to discuss with a clinician, not a target to chase.

Cognitive decline

Elevated triglycerides and low HDL are associated with greater risk of cognitive decline and dementia. Cerebral insulin resistance — often called “type 3 diabetes” — is one of the proposed mechanisms for Alzheimer’s disease.

A 2025 longitudinal analysis combined with a two-sample Mendelian randomization study (using SHARE waves 6–8, 2015–2019) found that adults in the highest TG/HDL-C quartile had a 43% higher risk of cognitive impairment over 4 years (OR 1.43, 95% CI 1.01–2.03), with worse performance on memory, recall, verbal fluency, and numeracy tasks. Crucially, the Mendelian randomization arm supported a causal link rather than mere association — meaning genetically determined higher TG/HDL-C ratios predispose to cognitive decline independent of confounders.

Metabolic syndrome

The TG/HDL ratio is one of the best predictors of metabolic syndrome — a condition that includes:

• Abdominal obesity (waist circumference > 40 in / 102 cm in men, > 35 in / 88 cm in women)
• High blood pressure
• Elevated blood glucose
• High triglycerides
• Low HDL

Metabolic syndrome is associated with significant acceleration of biological aging and increased risk of nearly all chronic diseases.

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How to test the TG/HDL ratio

The right test

The TG/HDL ratio is calculated from a simple lipid panel (or lipid profile), which includes:

• Total cholesterol
• LDL cholesterol
• HDL cholesterol
• Triglycerides

It’s a routine test, inexpensive and available at any laboratory.

Preparation and fasting

To obtain reliable values:

• 12-hour fast before the blood draw (water is allowed)
• Avoid alcohol in the 48 hours prior (triglycerides are very sensitive to alcohol)
• Avoid intense exercise in the 24 hours prior
• Have blood drawn early morning (triglycerides have a circadian rhythm)

Recommended frequency

Risk profile	Frequency
Healthy, < 40 years	Every 2-3 years
Healthy, > 40 years	Annual
TG/HDL ratio > 2.0	Every 6 months (during optimization)
Metabolic syndrome or diabetes	Every 3-6 months

Integration with other biomarkers

For a complete picture of your metabolic health and biological aging, combine the TG/HDL ratio with:

• HbA1c — glycated hemoglobin (long-term insulin resistance)
• Fasting insulin — direct indicator of insulin resistance
• High-sensitivity CRP — systemic inflammation
• ApoB — total number of atherogenic particles
• Albumin — systemic protein predictor of mortality
• Homocysteine — methylation and cardiovascular risk

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7 evidence-based strategies to optimize the ratio

The good news: the TG/HDL ratio is one of the most responsive biomarkers to lifestyle interventions. Diet, exercise, and body weight can improve it by 50% or more in a few months.

1. Reduce refined carbohydrates and sugars

Why it works: Triglycerides don’t mainly come from dietary fats — they come from excess sugars and refined carbohydrates. The liver converts excess sugars into triglycerides through de novo lipogenesis.

How to do it:

• Eliminate sugary beverages (including fruit juices)
• Reduce white bread, refined pasta, sweets
• Limit concentrated fructose (agave, corn syrup)
• Substitute with complex carbohydrates: legumes, vegetables, whole grains

Expected result: 20-50% reduction in triglycerides in 4-8 weeks.

2. Increase omega-3 fatty acid consumption

Why it works: Omega-3 fatty acids (EPA and DHA) reduce hepatic triglyceride production and increase VLDL catabolism.

How to do it:

• Fatty fish 2-3 times per week (salmon, mackerel, sardines, anchovies)
• If needed, omega-3 supplement: 2-4 g/day of EPA+DHA
• Add flaxseeds and walnuts to your diet

Expected result: 15-30% reduction in triglycerides.

3. Exercise regularly (especially Zone 2 and resistance)

Why it works: Exercise increases lipoprotein lipase (LPL) activity, the enzyme that removes triglycerides from blood, and increases HDL levels.

How to do it:

• Zone 2 (moderate aerobic): 150-200 minutes/week — brisk walking, cycling, swimming at conversational intensity
• Resistance training: 2-3 sessions/week — increased muscle mass improves insulin sensitivity
• HIIT: 1-2 sessions/week — particularly effective for increasing HDL

Expected result: 5-15% increase in HDL, 10-30% reduction in triglycerides.

4. Lose visceral fat (even a few pounds make a difference)

Why it works: Visceral fat is metabolically active and produces inflammatory cytokines that worsen insulin resistance. Even a 5-7% body weight loss (8-11 lbs / 3.5-5 kg for a 154 lb / 70 kg person) can significantly improve the TG/HDL ratio.

How to do it:

• Create a moderate caloric deficit (300-500 kcal/day)
• Prioritize protein (1.2-1.6 g/kg of body weight) to preserve muscle mass
• Intermittent fasting (16:8) can be helpful for some individuals

Expected result: 20-40% reduction in TG/HDL ratio with 5-10% weight loss.

5. Limit alcohol (or eliminate it completely)

Why it works: Alcohol is metabolized by the liver and directly stimulates triglyceride production. Even moderate amounts can significantly increase triglycerides in predisposed individuals.

How to do it:

• Completely eliminate alcohol for 30 days and reassess triglycerides
• If you choose to consume alcohol, limit to 1-2 glasses of red wine per week (not per day)
• Absolutely avoid beer and sugary cocktails

Expected result: 10-50% reduction in triglycerides (highly variable based on previous consumption).

6. Adopt a Mediterranean-type diet

Why it works: The Mediterranean diet combines many of the previous interventions into a sustainable eating pattern: rich in omega-3 (fish), fiber (vegetables and legumes), monounsaturated fats (olive oil), low in refined sugars.

How to do it:

• Extra virgin olive oil as the main fat (30-40 mL/day)
• Vegetables at every meal
• Legumes at least 3-4 times per week
• Nuts (30 g/day): walnuts, almonds, hazelnuts
• Fish 2-3 times per week

Expected result: Overall improvement in lipid profile with 20-35% reduction in TG/HDL ratio.

7. Optimize sleep

Why it works: Chronic sleep deprivation (< 6 hours) increases insulin resistance, cortisol levels, and triglycerides, and reduces HDL. A study showed that sleeping less than 6 hours per night is associated with a 30% increase in triglycerides.

How to do it:

• Goal: 7-9 hours per night
• Maintain regular schedule (even on weekends)
• Avoid bright screens 1 hour before bed
• Cool room (64-68°F / 18-20°C), dark and quiet

Expected result: Normalization of triglycerides and HDL in 4-8 weeks.

Advanced tip: Combine at least 3-4 of these strategies simultaneously to get maximum synergistic effect. Mediterranean diet + regular exercise + weight loss + alcohol reduction can improve the TG/HDL ratio by 50-70% in 3-6 months.

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How SuperAge tracks triglycerides, HDL, and your biological age

Monitoring the TG/HDL ratio is simple with a spreadsheet. But integrating it into the overall picture of your biological aging — along with dozens of other biomarkers — requires a dedicated tool.

Automatic blood biomarker tracking

SuperAge supports monitoring of over 64 biomarkers from your blood tests, including:

• Triglycerides
• HDL cholesterol
• LDL cholesterol
• Total cholesterol
• Total cholesterol/HDL ratio
• Non-HDL cholesterol

You can enter values manually or scan your lab results PDF — the app automatically extracts values using artificial intelligence.

Biological age calculation

SuperAge uses two scientifically validated algorithms to calculate your biological age:

• PhenoAge (Levine et al., 2018) — based on 9 blood biomarkers
• KDM Biological Age (Klemera-Doubal method) — uses 9 biomarkers including total cholesterol as a direct variable

Total cholesterol — closely correlated with the TG/HDL ratio — is one of the parameters used in the KDM calculation. Optimizing your lipid profile directly contributes to reducing your calculated biological age.

Trends over time

SuperAge shows you the trend of each individual biomarker over time, so you can verify if your strategies are working. After 3-6 months of lifestyle intervention, you can repeat your tests and see the improvement in the TG/HDL ratio and your overall biological age.

Download SuperAge and start monitoring your lipid profile along with your biological age.

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Frequently asked questions

How do you calculate the triglycerides/HDL ratio?

Divide the triglycerides value (in mg/dL) by the HDL cholesterol value (in mg/dL). For example: triglycerides 120 mg/dL ÷ HDL 60 mg/dL = ratio 2.0. If your values are in mmol/L, the ratio is calculated the same way but the reference thresholds are different (< 0.87 is ideal).

What is a good triglycerides/HDL ratio?

A ratio below 2.0 is considered good, but for optimal longevity the goal is below 1.5 for women and below 2.0 for men. The ideal range — associated with centenarian profiles — is below 1.0.

Can the TG/HDL ratio predict diabetes?

Yes. An elevated TG/HDL ratio is one of the best indirect predictors of insulin resistance, which is the pre-diabetic condition. Several studies have shown that a ratio > 3.0 is strongly associated with insulin resistance, even when fasting glucose is still normal.

How long does it take to improve the TG/HDL ratio?

With significant lifestyle changes (diet, exercise, weight loss), triglycerides can improve in 2-4 weeks. HDL responds more slowly — generally 2-3 months of consistent exercise are needed to see significant increases. The overall ratio can improve by 30-50% in 3-6 months.

Does the TG/HDL ratio affect biological aging?

Absolutely yes. An elevated ratio indicates insulin resistance, chronic inflammation, and metabolic dysfunction — all factors that accelerate cellular aging. Optimizing the TG/HDL ratio can help reduce your calculated biological age with algorithms like PhenoAge and KDM.

Is it better to lower triglycerides or raise HDL?

Both are important, but in practice interventions that work for one often improve the other as well. Reducing refined carbohydrates lowers triglycerides. Regular exercise increases HDL. The Mediterranean diet improves both. Focus on the ratio rather than a single value.

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Key takeaways

• The TG/HDL ratio is one of the best predictors of insulin resistance, cardiovascular risk, and accelerated aging — more informative than total cholesterol or LDL alone
• Optimal values for longevity are < 2.0 for men and < 1.5 for women; the centenarian profile is typically < 1.0
• A ratio around or above 3.0 can signal a small, dense LDL pattern — the more atherogenic type for arteries
• Blue Zone centenarians consistently present excellent TG/HDL ratios, with high HDL and low triglycerides
• 7 scientific strategies can improve the ratio by 50-70%: reduce sugars and refined carbohydrates, omega-3, exercise, visceral fat loss, limit alcohol, Mediterranean diet, optimize sleep
• SuperAge monitors triglycerides, HDL, and over 60 other biomarkers to calculate your biological age with PhenoAge and KDM algorithms

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Start your journey toward an optimal lipid profile today

The triglycerides/HDL ratio is one of those rare biomarkers that are easy to measure, highly informative, and — most importantly — deeply modifiable.

You don’t need expensive drugs or sophisticated genetic tests. A simple lipid panel, which you can do with any routine blood test, gives you access to one of the most powerful predictors of biological aging. And with the right strategies, you can significantly improve it in a few months.

Ready to take control? Download SuperAge and start monitoring your TG/HDL ratio along with your biological age — all in one app, directly from your iPhone.

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If triglycerides are rising, insulin and triglycerides together shows how fasting insulin changes the metabolic-risk read.

References

1. Jeppesen J, et al. — “Low triglycerides-high HDL cholesterol and risk of ischemic heart disease.” Arch Intern Med. Study that demonstrated up to 16x higher cardiovascular risk in the highest TG/HDL quartile.
2. Borrayo-Sánchez G, et al. — “TG/HDL-C Ratio as Surrogate Biomarker for Insulin Resistance.” Biomedicines, 2024. Systematic review of 32 studies and 49,782 participants showing TG/HDL as a useful but context-dependent surrogate marker for insulin resistance.
3. Barzilai N, et al. — “Unique lipoprotein phenotype and genotype associated with exceptional longevity.” JAMA, 2003. Study on Ashkenazi centenarians with elevated HDL.
4. Hanak V, et al. — “Accuracy of the triglyceride to HDL-C ratio for estimation of LDL particle size.” Clin Chem, 2004. Small, dense LDL threshold reported as a molar ratio > 1.33, roughly equivalent to > 3.0 when values are entered in mg/dL; broader phenotype-B studies used cutoffs closer to 3.8.
5. DeFilippis AP, et al. — “Triglyceride to high-density lipoprotein ratio in women.” J Am Heart Assoc, 2018. Gender differences in TG/HDL ratio and metabolic risk.
6. Pes GM, et al. — “Cholesterol paradox in Sardinian Blue Zone centenarians.” PMC, 2025. The cholesterol paradox in Sardinian centenarians.
7. “The triglyceride HDL cholesterol ratio predicts sarcopenia risk in an aging National cohort from China.” Scientific Reports, 2026. CHARLS cohort (n=2,481, age 60+) showing higher TG/HDL-C quartiles are protective against incident sarcopenia in the elderly (OR 0.34 for Q3, OR 0.55 for Q4 vs lowest quartile) — the lipid paradox of aging.
8. “Association Between Ratio of Triglycerides to HDL-C and Cognitive Impairment: A Longitudinal Population-Based Analysis and Mendelian Randomization Study.” ScienceDirect, 2025. SHARE waves 6–8, 43% higher cognitive impairment risk in highest TG/HDL-C quartile (OR 1.43, 95% CI 1.01–2.03) with causal link supported by MR.
9. “Triglyceride/high density lipoprotein cholesterol index and future cardiovascular events in diabetic patients without known cardiovascular disease.” Scientific Reports, 2025. HR 1.89 (95% CI 1.45–2.47) for CVD events in high TG/HDL-C diabetic patients.
10. “Guidelines for the Management of Dyslipidemia.” Endotext/NCBI Bookshelf, updated 2026. LDL-C and non-HDL-C remain treatment anchors; ApoB is useful for risk assessment when triglycerides are elevated, diabetes or metabolic syndrome is present, or LDL-C is low.
11. Levine ME, et al. — “An epigenetic biomarker of aging for lifespan and healthspan.” Aging, 2018. PhenoAge algorithm for biological age calculation.

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Last updated: June 2026. This article is periodically reviewed to ensure accuracy.