I have been engaging with Chat GPT, which I have been enjoying lately. However, some of these conversations tend to present complex knowledge. This particular exchange highlights the interconnectedness of our bodily processes and how one issue can impact another. What’s intriguing, as indicated in the title, is that diabetes is associated with inefficient glucose disposal, leading to a glucose problem, while TG levels indicate fat metabolism. This aspect adds an interesting dimension to our conversation.

Note: High triglyceride (TG) levels may be directly indicative of insulin resistance. This condition often results in carbohydrates being converted into fat, which then shows up as elevated TGs in blood tests. It’s possible that if you had been overeating in the days leading up to the test, the high TG levels could directly reflect insulin resistance or even signal an increased risk of diabetes.

Background: A student shared his blood test results with me, revealing high glucose and high TG’s. Despite this concerning revelation, their expert attributed it all to low Vitamin D (Is 30 low for an Indian) and advised him not to worry.

I am unsure how the doctor interpreted the report because these factors appear extremely serious for a 20-year-old individual from my perspective. It’s a matter of his overall well-being. This discussion elaborates on why this is significant…

Note: This discussion does not constitute medical advice, and I am not qualified to provide such advice. Please consult your doctor for any health concerns. However, it is my hope that this information will contribute to your understanding of the subject.

Me: If HbA1C, fasting glucose, and TGs are high then does that surely mean a defective metabolic machinery and its a case of what we know as metabolic syndrome?

ChatGPT: explains basics as usual and here is the summary:

“Having high levels of HbA1c, fasting glucose, and triglycerides can be indicative of metabolic syndrome, but a full diagnosis usually requires assessing additional factors, including blood pressure, waist circumference, and HDL cholesterol levels. If you or someone else is experiencing these issues, it’s important to consult a healthcare professional for a comprehensive evaluation and personalized recommendations.”

Me: I beg to differ with you. HDL cholesterol number mean nothing in the presence of high TG’s to the tune of 170. That clearly indicates the person has issue digesting glucose and/or fat and therefore unhealthy metabolically regardless of high HDL. And stop calling it good cholesterol. Science has advanced to that level where there is no good or bad cholesterol.

ChatGPT:

“You raise an important point about the complexity of lipid metabolism and the role of HDL cholesterol. The traditional view of HDL cholesterol as “good” and LDL cholesterol as “bad” is indeed being reconsidered in light of newer research.

So, while high triglycerides are a significant marker of metabolic dysfunction, HDL cholesterol levels can still provide useful information, especially in conjunction with other markers. The relationship between these markers and overall metabolic health is complex and multifaceted. Consulting a healthcare professional for a detailed evaluation and personalized advice remains essential.”

Me: No. I am not arguing HDL numbers mean nothing. But the numbers are more indicative of liver health in my view. I am discussing a different problem which is easier to check and repair. These could exist together or separately. As for numbers, Dava Feldman’s LHMR study demonstrates the varied internal management of lipid energy distribution. Even individuals with the same diet and similar age, height, weight, and waist measurements could have different numbers. For non-experts assessing lipid metabolism health, it’s more practical to focus on TG numbers while leaving the rest to their internal mechanistic machinery beyond their control and leave it to their doctor.
In this specific case I’m addressing, I’ve already mentioned poor glucose metabolism health indicated by Hb1Ac and fasting glucose levels.
So let me rephrase the question: Do high TG levels and high Hb1Ac indicate metabolic syndrome? In my view, yes. And all the other factors are outcomes from poor fat and glucose metabolism. Do you share this perspective now regardless of HDL number?

(PS: This is not the first time I am seeing TG numbers being ignored and HDL number is given more preference. It should be the other way around in my view.)

ChatGPT:

“In summary, high triglycerides and high HbA1c strongly suggest metabolic dysfunction and can be indicative of metabolic syndrome, even if other markers are not out of range. Focusing on triglyceride levels and glucose control is a practical approach for assessing metabolic health, particularly if one is dealing with these specific issues. This approach can be effective for identifying and managing metabolic dysfunction even in the face of individual variability.”

Me: Can we say – High TG’s is problem of fat disposal whereas low HDL is a problem of Liver?

ChatGPT:

It’s insightful to think of lipid metabolism in terms of specific issues with fat disposal and liver function. Here’s how that breaks down:

High Triglycerides (TG)

  • Fat Disposal: Elevated triglycerides often indicate that the body is having trouble managing or disposing of excess fats. This can be due to insulin resistance, poor dietary choices, or metabolic disturbances. High TGs are typically a sign that fat metabolism and disposal are not functioning optimally, which can be associated with issues like obesity and metabolic syndrome.

Low HDL Cholesterol

  • Liver Function and Lipid Transport: HDL cholesterol plays a key role in reverse cholesterol transport, where it helps transport excess cholesterol from the bloodstream back to the liver for processing and elimination. Low HDL levels can reflect issues with this process. It may suggest problems with how effectively the liver is managing and clearing cholesterol, though HDL’s role is multifaceted and influenced by various factors beyond just liver function.

In summary:

  • High TGs are more directly related to the body’s ability to handle and dispose of fats effectively.
  • Low HDL can indicate issues with cholesterol management and transport, involving liver function but also influenced by other factors like genetic predispositions and overall metabolic health.

Both markers are important for understanding different aspects of metabolic health, and they can interplay in complex ways. Addressing high triglycerides often involves improving fat metabolism and insulin sensitivity, while improving HDL levels can involve both lifestyle changes and addressing broader metabolic issues.

My Conclusion: Do not take high TG’s as nothing. They are the primary and most simplistic marker that can tell you a lot about your fat metabolism/health. It could be high because of poor disposal (poor metabolic health), Insulin Resistance (where glucose is getting converted to TG’s), high fat diet where it takes time to dispose, or it could be case of excess calories. The reason could any but the lesson is one – decrease the intake and/or burn more. Bring down the TG’s. They are an important marker in your blood panel.

Ques: What effects TG’s levels in the blood?

  • Insulin resistance,
  • Inefficient fat clearance
  • Excessive fat intake

Note: Genetics also play a role in your cholesterol numbers and its possible that one can absorb more cholesterol from another person eating the same diet.