Anyone can start here · Telehealth / national (compute over an existing lipid panel)
TG/HDL-C ratio — free insulin-resistance signal from an existing lipid panel — telehealth / national.
Fund it for $80. Proof lands onchain when it's done.
$80 proposed
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What the work involvesAnyone who already has a lipid panel on file — for example from this library's own ApoB packet — is sitting on a free, zero-additional-cost insulin-resistance signal nobody reads: the triglyceride-to-HDL ratio. Most consumer platforms either ignore it or apply it blindly to everyone, when the evidence says it simply doesn't work for one major population. This packet computes it correctly and names exactly who it applies to.
How this work is done
A documented method, so this packet comes out the same whoever does it.
Bring
- A recent accredited-lab lipid panel report already on file (TG and HDL-C values)
- A calculator
- The person's self-identified race/ethnicity, since the interpretation band depends on it
Steps
- 1. Locate a recent (ideally <=6 months old) accredited-lab lipid panel already on file; record the TG (mg/dL) and HDL-C (mg/dL) values with the draw date.
- 2. Compute TG/HDL-C = TG (mg/dL) / HDL-C (mg/dL); show the arithmetic in the record.
- 3. Ask the person's self-identified race/ethnicity ONLY to select the correct interpretation band — never to make any other inference.
- 4. For a general/white-cohort population: read >=3.0 as the McLaughlin 2003 insulin-resistance-associated threshold, flagging only.
- 5. For an African-American woman: state explicitly that the ratio is NOT interpretable for insulin resistance per Sumner et al. 2010 (Jackson Heart Study) -- record 'not applicable, do not use to rule out insulin resistance' rather than any numeric band.
- 6. For an African-American man: use the Sumner 2010 adjusted threshold of 2.5 (not the general 2.0/3.0 conventions), flagging only.
- 7. Regardless of band, name the insulin_resistance (fasting insulin + HOMA-IR) standard as the reliable next step if the person wants a direct, population-neutral measurement rather than this free derived signal alone; sign the record.
What counts as done
- TG and HDL-C values (mg/dL) transcribed from an existing accredited-lab lipid panel report, dated
- TG/HDL-C ratio computed and shown with the arithmetic
- Interpretation banded per the population-appropriate evidence: general/white-cohort threshold >=3.0 (McLaughlin 2003); African-American women — ratio explicitly NOT interpretable, stated as such, never used to reassure; African-American men — threshold 2.5, not 2.0 (Sumner 2010)
- The insulin_resistance (fasting insulin + HOMA-IR) standard named as the reliable, population-neutral alternative when this ratio's population limit applies or the result is ambiguous
Proof is measured against these, not judged by taste.
What is promised, and what is not.
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