U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

NCHS Data Brief ■ No. 198 ■ May 2015

Trends in Elevated Triglyceride in Adults: United States, 

2001–2012 

Margaret D. Carroll, M.S.P.H.; Brian K. Kit, M.D., M.P.H.; and David A. Lacher, M.D., M.Ed.

Key findings

Data from the National 

Health and Nutrition 

Examination Survey, 

2001–2012

● The percentage of adults 

aged 20 and over with elevated 

triglyceride (150 mg/dL or 

more) declined from 33.3% 

during 2001–2004 to 25.1% 

during 2009–2012.

● Percentages with elevated 

triglyceride decreased for both 

men and women—among men, 

from 37.3% for 2001–2004 

to 28.7% for 2009–2012, and 

among women, from 29.3% 

for 2001–2004 to 21.5% for 

2009–2012.

● For adults aged 60 and over, 

declines in elevated triglyceride 

levels were seen in both men 

(from 39.9% during 2001–2004 

to 24.8% during 2009–2012) 

and women (from 43.5% 

during 2001–2004 to 30.9% 

during 2009–2012). 

● Declines in elevated 

triglyceride levels were 

observed in overweight and 

obese men and women between 

2001–2004 and 2009–2012.

Elevated triglyceride is associated with cardiovascular disease (1). For adults 

aged 20 and over with elevated triglyceride, recommendations for therapeutic 

lifestyle changes include increased physical activity (2,3), weight loss (2,3), 

optimal nutrition-related practices (3), and smoking cessation (2). In this 

report, trends in the percentage of U.S. adults aged 20 and over with elevated 

triglyceride (150 mg/dL or more) (2,3) are examined using data from National 

Health and Nutrition Examination Surveys (NHANES) 2001–2004, 

2005–2008, and 2009–2012.

Keywords: cardiovascular disease • obesity • NHANES

What percentage of adults had elevated triglyceride during 

2009–2012, and were differences noted by age and sex?

Approximately one-quarter of adults aged 20 and over had elevated 

triglyceride levels during 2009–2012 (Figure 1). A greater percentage of men 

0

5

10

15

20

25

30

35

Both sexes Men Women

Figure 1. Age-adjusted and age-specific percentages of adults aged 20 and over with elevated 

triglyceride, by sex and age: United States, 2009–2012

1

Significantly less than adults aged 40–59 or 60 and over, p < 0.001. 2

Significantly greater than women of the same age group, p < 0.01. 3

Significantly greater than men aged 20–39 or 60 and over, p < 0.01. 4

Significant increasing age trend, p < 0.001.

NOTE: Elevated triglyceride is a triglyceride level greater than or equal to 150 mg/dl.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2009–2012. 

20 and over 20–39 40–59 60 and over

Percent

25.1

1

19.9

2

28.7

2

25.1

2,334.9

4

30.9

28.8 28.2

24.8

21.5

14.7

23.0
NCHS Data Brief ■ No. 198 ■ May 2015

■  2  ■

(28.7%) than women (21.5%) had elevated triglyceride levels. This sex difference was seen 

in adults aged 20–39 (25.1% men, 14.7% women) and 40–59 (34.9% men, 23.0% women). 

However, for adults aged 60 and over, no significant difference by sex was observed in the 

percentage with elevated triglyceride. A greater percentage of men aged 40–59 (34.9%) than men 

aged 20–39 (25.1%) or 60 and over (24.8%) had elevated triglyceride. For women, an increasing 

trend in elevated triglyceride occurred with age (14.7% for age group 20–39, 23.0% for 40–59, 

and 30.9% for 60 and over).

Did the percentage of adults with elevated triglyceride change between 

2001–2004 and 2009–2012?

A decreasing trend was observed in the percentage of adults with elevated triglyceride, 

from 33.3% during 2001–2004 to 25.1% during 2009–2012 (Figure 2). Declines in elevated 

triglyceride were observed both in men, from 37.3% during 2001–2004 to 28.7% during 

2009–2012, and in women, from 29.3% during 2001–2004 to 21.5% during 2009–2012. 

0

15

20

25

30

35

40

2001–2004 2005–2008 2009–2012

Percent

Men1

Both sexes1

Women1

Figure 2. Age-adjusted percentage of adults aged 20 and over with elevated triglyceride, by sex: United States, 2001–2012

1

Significant decreasing trend, p < 0.001.

NOTE: Elevated triglyceride is a triglyceride level greater than or equal to 150 mg/dL.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2001–2012.

Survey period
NCHS Data Brief ■ No. 198 ■ May 2015

■  3  ■

Did the trend in the percentage of adults with elevated triglyceride differ by 

sex and age between 2001–2004 and 2009–2012?

Among adults aged 60 and over from 2001–2004 to 2009–2012, the percentage with elevated 

triglyceride declined from 39.9% to 24.8% for men, and from 43.5% to 30.9% for women 

(Figure 3). For adults aged 40–59, a decreasing trend was seen in men (from 44.4% during 

2001–2004 to 34.9% during 2009–2012) and in women (from 28.7% during 2001–2004 to 

23.0% during 2009–2012). For younger adults, aged 20–39, the percentage of men with elevated 

triglyceride did not change significantly. However, the percentage of women in the youngest age 

group with elevated triglyceride declined from 21.6% during 2001–2004 to 14.7% during 

2009–2012. 

0

10

20

30

40

50

2009–

2012

2005–

2008

2001–

2004

Percent

1

40–59

20–39

2

60 and over

Figure 3. Percentage of adults aged 20 and over with elevated triglyceride, by sex and age: United States, 2001–2012

1

Significant decreasing trend, p < 0.01. 2

Significant decreasing trend, p < 0.001. 3

Significant decreasing trend, p < 0.05.

NOTE: Elevated triglyceride is a triglyceride level greater than or equal to 150 mg/dL.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2001–2012.

2009–

2012

2005–

2008

2001–

2004

3

40–59

1

20–39

2

60 and over

Men Women

Survey period
NCHS Data Brief ■ No. 198 ■ May 2015

■  4  ■

Did the trend in the percentage of adults with elevated triglyceride differ by 

sex and race and Hispanic origin between 2001–2004 and 2009–2012?

Decreasing trends in the percentage with elevated triglyceride were seen in Mexican-American 

women (from 39.6% for 2001–2004 to 27.8% for 2009–2012), but not in Mexican-American 

men (Figure 4). For non-Hispanic white adults, declining trends in the percentage with elevated 

triglyceride were observed from 2001–2004 to 2009–2012 both in men (from 39.1% to 27.8%) 

and in women (from 29.6% to 22.7%). No change was observed in the percentage of 

non-Hispanic black men or women with elevated triglyceride. During the entire study period, 

the percentage of adults with elevated triglyceride was consistently lower in non-Hispanic black 

adults than in non-Hispanic white or Mexican-American adults. No consistent difference was 

found in the percentage with elevated triglyceride between non-Hispanic white and 

Mexican-American adults across the survey periods.

0

10

20

30

40

50

2009–

2012

2005–

2008

2001–

2004

Percent

Mexican-American

Non-Hispanic black3

Non-Hispanic white1

Figure 4. Age-adjusted percentage of adults aged 20 and over with elevated triglyceride, by sex and race and ethnicity: 

United States, 2001–2012 

1

Significant decreasing linear trend, p < 0.001. 2

Significant decreasing linear trend, p < 0.01. 3

Significantly lower than non-Hispanic white or Mexican-American adults of the same sex, p < 0.001.

NOTE: Elevated triglyceride is a triglyceride level greater than or equal to 150 mg/dL.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2001–2012.

2009–

2012

2005–

2008

2001–

2004

Mexican-American1

Non-Hispanic black3

Non-Hispanic white2

Men Women

Survey period
NCHS Data Brief ■ No. 198 ■ May 2015

■  5  ■

Did the trend in the percentage with elevated triglyceride differ by sex and 

weight status between 2001–2004 and 2009–2012? 

Decreasing trends were noted in the percentage of obese men with elevated triglyceride, from 

48.0% for 2001–2004 to 38.7% for 2009–2012 (Figure 5). Decreasing trends in elevated 

triglyceride were also seen in overweight men (from 40.7% for 2001–2004 to 27.5% for 

2009–2012). However, the percentage of normal weight men with elevated triglyceride did not 

change during the study period. 

Decreasing trends were observed in the percentage of obese women with elevated triglyceride 

during 2001–2012 (from 39.9% for 2001–2004 to 31.9% for 2009–2012), as well as overweight 

women (from 34.0% for 2001–2004 to 22.9% for 2009–2012). The percentage of normal weight 

women with elevated triglyceride also decreased linearly over the same time period 

(from 18.0% to 9.3%). 

0

10

20

30

40

50

2009–

2012

2005–

2008

2001–

2004

Percent

Obese1

Obese1

Normal weight

Normal weight2 

Overweight2

Overweight2

Figure 5. Age-adjusted percentage of adults aged 20 and over with elevated triglyceride, by sex and classification of body 

mass index: United States, 2001–2012

1

Significant decreasing trend, p < 0.01. 2

Significant decreasing trend, p < 0.001.

NOTE: Elevated triglyceride is a triglyceride level greater than or equal to 150 mg/dL.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2001–2012.

2009–

2012

2005–

2008

2001–

2004

Men Women

Survey period
NCHS Data Brief ■ No. 198 ■ May 2015

■  6  ■

Summary 

The percentage of adults aged 20 and over with elevated triglyceride (150 mg/dL or more) 

declined between 2001–2004 and 2009–2012. During 2009–2012, about one-quarter of the 

U.S. adult population aged 20 and over had elevated triglyceride. 

Declining trends in the percentage of adults with elevated triglyceride since 2001–2004 occurred 

for men and for women overall; for adults in age groups 40–59 and 60 and over; among 

non-Hispanic white men and non-Hispanic white women; and among overweight men and 

women and obese men and women. 

The lower percentage of elevated triglyceride for non-Hispanic black adults, compared with 

Mexican-American or non-Hispanic white adults, has been documented (2). One possible 

explanation is that levels of lipoprotein lipase (the enzyme responsible for clearing triglyceridecontaining lipoproteins from the circulation) are higher in black persons than in white persons (4).

Factors affecting triglyceride levels include a sedentary lifestyle (2,3), increased body weight 

(2,3), and cigarette smoking (2). Furthermore, simple carbohydrates (including added sugars 

and fructose), trans-fatty acids, and alcohol increase triglyceride, whereas monounsaturated 

and polyunsaturated fatty acids and marine-based omega-3 products may reduce triglyceride 

(3). Decreases in the percentage of adults who smoke cigarettes (5), the decline in plasma 

concentrations of trans-fatty acids (6), and the increased percentage of adults taking cholesterollowering medications (7) could have contributed to the declining trends in elevated triglyceride. 

Limited results from clinical trials have demonstrated a 10%–30% reduction in triglyceride 

with statin monotherapy in patients with elevated triglyceride at baseline (3). However, further 

clinical outcome trials are necessary to definitively demonstrate the benefits of statins on reducing 

triglyceride levels. 

Definitions

Elevated triglyceride: A triglyceride level of 150 mg/dL or more.

Weight status

 Body mass index (BMI): Weight in kilograms divided by height in meters squared 

(kg/m2

), rounded to the nearest tenth.

 Normal weight: BMI of at least 18.5 kg/m2

 but less than 25 kg/m2.

 Overweight: BMI of at least 25 kg/m2

 but less than 30 kg/m2.

 Obesity: BMI greater than or equal to 30 kg/m2

.
NCHS Data Brief ■ No. 198 ■ May 2015

■  7  ■

Data sources and methods 

Results presented in this report are based on data from three NHANES survey periods: 

2001–2004 (8), 2005–2008 (8,9), and 2011–2012 (9). These cross-sectional surveys are designed 

to monitor the health and nutritional status of the U.S. civilian noninstitutionalized population 

(8,9). Each survey consists of interviews conducted in participants’ homes and standardized 

physical examinations in a mobile examination center (MEC), including laboratory tests. Onehalf of MEC examination participants aged 12 and over were randomly assigned to the morning 

session and instructed to fast for at least 8 hours prior to venipuncture. The percentage with 

elevated triglyceride is based on adults (aged 20 and over) examined in the morning and fasting 

for at least 8.5 hours but no more than 23 hours prior to venipuncture. Adults with data on 

triglyceride totaled 4,115 for NHANES 2001–2004, 4,306 for NHANES 2005–2008, and 4,881 

for NHANES 2009–2012.

The NHANES sample is selected through a complex multistage probability design (8,9). Data 

collection is based on a representative sample covering all ages of the civilian noninstitutionalized 

population. Sample weights, accounting for differential selection probabilities, nonresponse, and 

noncoverage, are incorporated in the estimation process. In estimating the percentage of adults 

with elevated triglyceride, morning fasting sample weights were used. All variance estimates 

accounted for the complex survey design using Taylor series linearization (10). Percentage 

estimates for the total adult population were age-adjusted by the direct method to the U.S. Census 

2000 population using age groups 20–39, 40–59, and 60 and over (11). Differences between 

groups were tested using a Student’s t statistic with the appropriate degrees of freedom at the 

p < 0.05 significance level (where p is the probability of rejecting the null hypothesis when it 

is true). Linear survey trends were tested using orthogonal contrast matrices. All differences 

reported are statistically significant unless otherwise indicated. Statistical analyses were 

conducted using SAS System for Windows release 9.3 (SAS Institute Inc., Cary, N.C.) and 

SUDAAN release 11.0 (RTI International, Research Triangle Park, N.C.).

About the authors

Margaret D. Carroll, Brian K. Kit, and David A. Lacher are with CDC’s National Center 

for Health Statistics, Division of Health and Nutrition Examination Surveys.

References

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Am J Cardiol 81(4A):7B–12B. 1998.

2. National Institutes of Health, National Heart, Lung and Blood Institute. Third report of the 

National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and 

Treatment of High Blood Cholesterol in Adults (Adult treatment panel III): Final report. NIH 

publication no. 02–5215. 2002.

3. Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN, et al. Triglycerides 

and cardiovascular disease: A scientific statement from the American Heart Association. 

Circulation 123(20):2292–333. 2011.
NCHS Data Brief ■ No. 198 ■ May 2015

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POSTAGE & FEES PAID 

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PERMIT NO. G-284

4. Summer AE, Finley KB, Genovese DJ, Criqui MH, Boston RC. Fasting 

triglyceride and the triglyceride-HDL cholesterol ratio are not markers of 

insulin resistance in African Americans. Arch Intern Med 165(12):1395–400. 

2005.

5. Ward BW, Schiller JS, Freeman G. Early release of selected estimates 

based on data from the January–September 2013 National Health Interview 

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http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201403.pdf. 

6. Vesper HW, Kuiper HC, Mirel LB, Johnson CL, Pirkle JL. Levels of 

plasma trans-fatty acids in non-Hispanic white adults in the United States in 

2000 and 2009. JAMA 307(6):562–3. 2012.

7. Gu Q, Paulose-Ram R, Burt VL, Kit BK. Prescription cholesterollowering medication use in adults aged 40 and over: United States, 

2003–2012. NCHS data brief, no 177. Hyattsville, MD: National Center for 

Health Statistics. 2014. Available from: 

http://www.cdc.gov/nchs/data/databriefs/db177.htm.

8. Curtin LR, Mohadjer LK, Dohrmann SM, et al. The National Health and 

Nutrition Examination Survey: Sample design, 1999–2006. National Center 

for Health Statistics. Vital Health Stat 2(155). 2012.

9. Curtin LR, Mohadjer LK, Dohrmann SM, et al. National Health and 

Nutrition Examination Survey: Sample design, 2007–2010. National Center 

for Health Statistics. Vital Health Stat 2(160). 2013.

10. Wolter KM. Taylor series methods. In: Introduction to variance 

estimation. 2nd ed. New York, NY: Springer Science+Business Media, LLC. 

2007. 

11. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. 

population. Healthy People 2010 Statistical Notes, no. 20. Hyattsville, MD: 

National Center for Health Statistics. January 2001.

Suggested citation 

Carroll MD, Kit BK, Lacher DA. Trends in 

elevated triglyceride in adults: United States, 

2001–2012. NCHS data brief, no 198. 

Hyattsville, MD: National Center for Health 

Statistics. 2015.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Kathryn S. Porter, M.D., M.S., Director

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