Nearly 3 in 10 Nanjing over-60s had high triglycerides with no diabetes and no cholesterol pills. A wide waist on its own barely moved the odds; extra weight on the scales did

Triglycerides are the fat your blood carries between meals, and a high fasting level is one of the earliest signs that the body's handling of fuel is slipping, years before blood sugar crosses the line into diabetes. Carrying extra weight is a well-known driver. What is less studied is how this plays out in older people who have not yet been diagnosed with anything, and whether it matters more where the weight sits. A study published in Frontiers in Nutrition on 27 October looked at exactly that group, in one of China's largest cities.

The data come from the Healthy Aging, Healthy Elders study, a survey of registered residents aged 60 and over in Nanjing in 2023. Households were drawn at random from 15 neighbourhoods in each of the city's 12 districts, and 93% of the people invited took part. From 32,735 recruits, the researchers removed 5,966 with diabetes and then 7,101 more who said they took medicine to lower their blood fats, so that every triglyceride reading reflected a body nobody was treating. That left 19,668 people, half men and half women, two thirds of them in their sixties. Staff measured height, weight and waist twice each and took a fasting blood sample.

Using the Chinese cut-off of 1.7 mmol/L (about 150 mg/dL), 29.3% had high triglycerides. The share climbed steeply with BMI: 22.6% of people at a normal weight, 33.1% of those overweight and 39.9% of those with obesity (China uses lower BMI lines than the WHO: 24 for overweight and 28 for obesity). After allowing for age, sex, schooling, smoking, drinking, exercise, screen time, meat and vegetable intake and blood pressure, overweight came with 1.66 times the odds of high triglycerides and obesity with 2.14 times. A wide waist (90 cm or more for men, 85 cm for women, which applied to 57.7% of the group) came with 1.37 times the odds.

The surprise came when the two measures were combined. People with a normal waist but a BMI in the overweight range still had higher odds (1.52), and those heavy on both counts had the highest (2.20). But people with a wide waist and a normal BMI had odds of 1.04, statistically no different from people slim on both. That runs against the usual teaching that belly fat is the stronger signal, and the authors say plainly that it is not easy to explain. Their best guess is that earlier studies never separated the two, so a wide waist there often came bundled with a high BMI.

The exception was the oldest group. Among the 1,201 people aged 80 and over, a wide waist with a normal BMI did go with higher odds (1.85), and when the authors split that group by sex, the link held in men (2.73) but not in women. With so few people in each cell, that is a lead for future work rather than a finding to act on.

Some limits matter here. This is a single snapshot, so it shows which groups have high triglycerides, not what causes them. Lifestyle answers were self-reported, diet was reduced to whether people met meat and vegetable guidelines, and people with high blood pressure stayed in even though some blood pressure medicines can raise triglycerides; the survey did not record which drugs they took. The waist and BMI cut-offs are Chinese ones, lower than those used in Europe and North America, so the groups do not map neatly onto Western categories. What the study does show, in a large and carefully sampled group, is how common raised triglycerides are in older people who have never been told they have a problem.