VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL

VLDL test

VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL

Very low density lipoprotein test

VLDL stands for very low density lipoprotein. Lipoproteins are made up of cholesterol, triglycerides, and proteins. They move cholesterol, triglycerides, and other lipids (fats) to around the body.

VLDL is one of the three main types of lipoproteins. VLDL contains the highest amount of triglycerides. VLDL is a type of “bad cholesterol” because it helps cholesterol build up on the walls of arteries.

A lab test is used to measure the amount of VLDL in your blood.

Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.

A blood sample is needed. Most of the time blood is drawn from a vein located on the inside of the elbow or the back of the hand.

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

You may have this test to help assess your risk for heart disease. Increased levels of VLDL are linked to atherosclerosis. This condition can lead to coronary heart disease.

This test may be included in a coronary risk profile.

Normal VLDL cholesterol level is between 2 and 30 mg/dL.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

A high VLDL cholesterol level may be associated with a higher risk for heart disease and stroke. However, VLDL cholesterol level is rarely targeted when treatment for high cholesterol is done. Instead, LDL cholesterol level is more often the main target of therapy.

Veins and arteries vary in size from one person to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

The risks associated with having blood drawn are slight, but may include:

  • Excessive bleeding
  • Fainting or feeling lightheaded
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

There is no direct way of measuring VLDL. Most labs estimate your VLDL your triglycerides level. It is about one fifth of your triglycerides level. This estimate is less accurate if your triglycerides level is above 400 mg/dL.

Chen X, Zhou L, Hussain MM. Lipids and dyslipoproteinemia. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 17.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393 www.ncbi.nlm.nih.gov/pubmed/30423393.

Robinson JG. Disorders of lipid metabolism. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 195.

Last reviewed on: 6/28/2019

Reviewed by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Source: https://www.mountsinai.org/health-library/tests/vldl-test

Making sense of cholesterol tests

VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL

Time to get your cholesterol checked. Okay, but which test should you get? It's not so simple anymore. Here is a rundown of some of the choices and their pros and cons:

Total cholesterol. This is the simplest and least expensive test. The test doesn't require any sophisticated lab work, either. The simple, do-it-yourself home cholesterol tests measure total cholesterol.

But total cholesterol includes both “good” high-density lipoprotein (HDL) cholesterol, and the “bad” varieties, chiefly low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL).

So, if your total cholesterol is in the desirable category, it's possible that you may have unhealthy levels of HDL (too low) and LDL and VLDL (too high). Think of total cholesterol as a first glimpse, a peek.

Doctors are not supposed to make any treatment decisions this number alone.

Cholesterol levels can be lowered by stress (physical or psychological) or infection. An injury, cancer, stroke, or heart attack may have the same effect. So, if your cholesterol levels are unusually high or low, your doctor will probably want to repeat the test some weeks later. Abnormal readings may also lead to tests for other medical problems.

HDL cholesterol. HDL wins its laurels as the “good” cholesterol because it sponges up cholesterol from blood vessel walls and ferries it to the liver for disposal. In contrast, LDL deposits the harmful fat in vessel walls.

An HDL level of 60 or above is associated with a lower risk of heart disease, and below 40 is associated with a higher risk.

  • Makes up 20%–30% of total cholesterol
  • The “good” cholesterol
  • Moves cholesterol from arteries to the liver.
  • Makes up 60%–70% of total cholesterol
  • Main form of “bad” cholesterol
  • Causes build-up of plaque inside arteries.
  • Makes up 10%–15% of total cholesterol
  • With LDL, the main form of “bad” cholesterol
  • A precursor of LDL.

LDL cholesterol. The LDL measurement is usually considered the most important for assessing risk and deciding on treatment. The definition of a healthy level keeps on getting lower.

For people at low risk of heart disease, an LDL of less than 100 is desirable, However, people at higher risk of heart disease, an LDL of less than 70 or perhaps even lower is considered “optimal.

” Some experts say that an LDL of less than 70 would be a healthy LDL goal for all of us.

Your LDL is computed by plugging the measurements for total cholesterol, HDL, and triglycerides into a: LDL = Total cholesterol – HDL – (Triglycerides ÷ 5). LDL can also be measured directly in a non-fasting blood sample.

You have to fast for about 10 hours before the test because triglyceride levels can shoot up 20%–30% after a meal, which would throw off the equation. Alcohol also causes a triglyceride surge, so you shouldn't drink alcohol for 24 hours before a fasting cholesterol test.

The numbers to know
TestGenerally desirable level
Total cholesterolunder 200 mg/dL
LDL (bad) cholesterolunder 100 mg/dL
HDL (good) cholesterolover 60 mg/dL
Triglyceridesunder 150 mg/dL

C-reactive protein (CRP) is a protein in the blood that increases with inflammation.

Because atherosclerosis is fundamentally an inflammatory process, many experts believe that CRP testing could lead to early detection and therefore save lives.

The American Heart Association says CRP tests are most helpful for people at intermediate risk for heart disease, but not those at the low and high ends of the risk spectrum.

You should get a fasting cholesterol test at least once every five years for everyone beginning at age 20. A fasting cholesterol test gives you the important numbers: total, LDL, and HDL cholesterol, as well as triglyceride levels.

For more information, read “11 foods that lower cholesterol.”

Image: blueshot/Getty Images

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Source: https://www.health.harvard.edu/heart-health/making-sense-of-cholesterol-tests

Understanding Your Cholesterol Numbers

VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL
Cholesterol in the blood and blood vessel.

Your total blood cholesterol is a measure of the cholesterol components LDL (low-density lipoprotein) cholesterol, HDL (high-density lipoprotein) cholesterol, and VLDL (very low-density lipoprotein, which is the triglyceride-carrying component of lipids). Total cholesterol values cannot be interpreted in the absence of the cholesterol components listed below.

What are the kinds of cholesterol?

LDL (low density-lipoprotein) cholesterol is also called “bad” cholesterol. LDL can build up on the walls of your arteries and increase your chances of getting heart disease. If you do not have heart or blood vessel disease and are not at high risk for developing heart disease, the following guidelines apply.

Your LDL cholesterol number is:

  • Optimal if it is less than 100.
  • Near optimal/above optimal if it is 100-129.
  • Borderline high if it is 130-159.
  • High if it is 160-189.
  • Very high if it is 190 or above.

The treatment goal for individuals with heart disease or blood vessel disease is to reach an LDL of less than 70. The treatment goal for high-risk individuals (those with diabetes or other multiple risk factors for heart disease) is to reach an LDL of at least less than 100.

HDL (high-density lipoprotein) cholesterol is also called “good” cholesterol. HDL protects against heart disease by taking the bad cholesterol your blood and keeping it from building up in your arteries. Your HDL cholesterol number is:

  • Low (and considered a risk factor) if it is less than 40.
  • Good (and able to help lower your risk of heart disease) if it is 60 or more.

Triglycerides are the chemical form in which most fat exists in food and the body. Triglycerides are mostly carried in VLDL and chylomicrons. VLDL comes from the liver and also has cholesterol. Chylomicrons come from dietary fat.

Along with cholesterol, triglycerides form plasma lipids. Excess triglycerides in plasma have been linked to the occurrence of coronary artery disease in some people. cholesterol, increases in triglyceride levels can be detected by plasma measurements. These measurements should be made after an overnight food and alcohol fast. Your triglyceride numbers are:

  • Normal if they are less than 150.
  • Borderline high if they are 150-199.
  • High if they are 200-499.
  • Very high if they are 500 or higher.

Who should get a cholesterol screening?

Everyone over the age of 20 should get their cholesterol levels measured at least once every 5 years. The test that is performed is a blood test called a lipoprotein profile. That includes:

  • Total cholesterol level
  • HDL
  • Triglycerides

LDL level is calculated from the above 3 values.

What affects cholesterol levels?

A variety of factors can affect your cholesterol levels. They include:

  • Diet: Saturated fat, trans fat and cholesterol in the food you eat increase cholesterol levels. Try to reduce the amount of saturated fat, trans fat and cholesterol in your diet. This will help lower your blood cholesterol level. Saturated fat and trans fat have the most impact on blood cholesterol.
  • Weight: In addition to being a risk factor for heart disease, being overweight can also increase your triglycerides. Losing weight may help lower your triglyceride levels and raise your HDL.
  • Exercise: Regular exercise can lower total cholesterol levels. Exercise has the most effect on lowering triglycerides and raising HDL. You should try to be physically active for 30 minutes on most days.
  • Age and gender: As we get older, cholesterol levels rise. Before menopause, women tend to have lower total cholesterol levels than men of the same age. After menopause, however, women's LDL levels tend to rise and HDL can drop.
  • Heredity: Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

Last reviewed by a Cleveland Clinic medical professional on 06/28/2018.

References

Get useful, helpful and relevant health + wellness information enews

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Source: https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean

How the Test is Performed

A blood sample is needed. Most of the time blood is drawn from a vein located on the inside of the elbow or the back of the hand.

How the Test will Feel

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

Why the Test is Performed

You may have this test to help assess your risk for heart disease. Increased levels of VLDL are linked to atherosclerosis. This condition can lead to coronary heart disease.

This test may be included in a coronary risk profile.

Normal Results

Normal VLDL cholesterol level is between 2 and 30 mg/dL.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

A high VLDL cholesterol level may be associated with a higher risk for heart disease and stroke. However, VLDL cholesterol level is rarely targeted when treatment for high cholesterol is done. Instead, LDL cholesterol level is more often the main target of therapy.

Risks

Veins and arteries vary in size from one person to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

The risks associated with having blood drawn are slight, but may include:

  • Excessive bleeding
  • Fainting or feeling lightheaded
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

Considerations

There is no direct way of measuring VLDL. Most labs estimate your VLDL your triglycerides level. It is about one fifth of your triglycerides level. This estimate is less accurate if your triglycerides level is above 400 mg/dL.

References

Semenkovich CF. Disorders of lipid metabolism. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 206.

Stone NJ, Robinson JG, Lichtenstein AH, et al. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. Ann Intern Med. 2014;160(5):339-343. PMID: 24474185 www.ncbi.nlm.nih.gov/pubmed/24474185.

Source: https://m.ufhealth.org/vldl-test

Non-HDL cholesterol explained

VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL

Image: © jarun011/Thinkstock

Q. My recent cholesterol test result included “non-HDL cholesterol.” What is the significance of this number?

A. Your non-HDL cholesterol result refers to your total cholesterol value minus your HDL cholesterol. When you get your blood drawn for a cholesterol test (also known as a lipid profile or lipid panel), the report usually includes four numbers: low-density lipoprotein (LDL) cholesterol; high-density lipoprotein (HDL) cholesterol; triglycerides; and total cholesterol.

Although you might assume total cholesterol is simply the sum of your LDL and HDL, it also includes very-low-density lipoprotein (VLDL). These particles carry triglycerides to tissues and eventually become LDL.

LDL, it also causes cholesterol to build up on the inside of arteries, creating artery-clogging plaque. Both are considered undesirable, so the higher your LDL and VLDL values, the higher your risk of heart disease.

There is no simple, direct way to measure VLDL cholesterol, which is why it is normally not noted on a routine cholesterol screening.

VLDL cholesterol is usually estimated as a percentage of your triglyceride value. In fact, although a direct measurement of LDL is possible, most laboratories do not currently do this.

Instead, they calculate LDL using a simple formula your other lipid values.

For most people, a calculated LDL provides a good estimate of the directly measured LDL. But a calculated LDL becomes less accurate as triglycerides get higher, especially above 400 milligrams per deciliter (mg/dL), which is considered very high. (Normal values are less than 150 mg/dL.) In such cases, the only way to get an accurate measurement is to measure LDL directly.

Note that blood levels of triglycerides vary depending on when and what you have eaten, which is why most cholesterol tests are done after a person has fasted for at least 12 hours. That way, the results can be more easily compared between people.

However, the non-HDL cholesterol calculation does not rely on a triglyceride value, so there is no need to fast; the results are similar whether you have fasted or not.

Furthermore, the non-HDL cholesterol value reflects all of the major lipoproteins linked with a higher risk of cardiovascular disease. Some lipid experts argue that the non-HDL cholesterol value is better than the LDL cholesterol value for predicting heart disease.

In fact, a common risk calculator (cvriskcalculator.com) relies on the non-HDL cholesterol number.

So why do most physicians still focus on LDL values? Large clinical trials have shown that drugs such as statins lower LDL cholesterol levels and also reduce the risk of cardiac events.

The lower your LDL, the lower your cardiovascular risk appears to be. Many guidelines also have established target LDL levels for different levels of risk.

So for now, LDL remains the value of most relevance for doctors.

— by Deepak L. Bhatt, M.D., M.P.H.
Editor in Chief, Harvard Heart Letter

For up-to-date information to help you or a loved one keep cholesterol in check, get the Harvard Special Health Report Managing Your Cholesterol.

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Source: https://www.health.harvard.edu/heart-health/non-hdl-cholesterol-explained

VLDL

VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL

VLDL stands for very low density lipoprotein. Lipoproteins are made up of cholesterol, triglycerides, and proteins. They move cholesterol, triglycerides, and other lipids (fats) to around the body.

VLDL is one of the three main types of lipoproteins. VLDL contains the highest amount of triglycerides. VLDL is a type of “bad cholesterol” because it helps cholesterol build up on the walls of arteries.

A lab test is used to measure the amount of VLDL in your blood.

Understanding Your Cholesterol Report

VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL

  • How to Read Your Lipid Panel
  • What's Your Goal?

A lipid profile is a blood test that measures the amount of cholesterol and fats called triglycerides in the blood.

These measurements give the doctor a quick snapshot of what's going on in your blood. Cholesterol and triglycerides in the blood can clog arteries, making you more ly to develop heart disease.

Thus, these tests can help predict your risk of heart disease and allow you to make early lifestyle changes that lower cholesterol and triglycerides.

A report typically contains the following items, in this order:

  • Total cholesterol: An estimate of all the cholesterol in the blood (good HDL plus bad LDL, for example). Thus, a higher total cholesterol may be due to high levels of HDL, which is good, or high levels of LDL, which is bad. So knowing the breakdown is important.
  • Triglycerides: A type of blood fat.
  • High-density lipoprotein (HDL): Good cholesterol that helps protect against heart disease.
  • Low-density lipoprotein (LDL): Bad cholesterol and a major contributor to clogged arteries.

Some reports also include:

  • Total cholesterol to HDL ratio: The amount of total cholesterol divided by HDL. This number is useful in helping doctors predict the risk of developing atherosclerosis (plaque build-up inside the arteries).
  • Very low-density lipoprotein (VLDL): Another type of bad cholesterol that builds up inside the arteries.

Total Blood (Serum) Cholesterol

In general, doctors recommend that you try to keep this number under 200 mg/dL. Levels over 200 mg/dL — depending on the breakdown of LDL versus HDL — may mean you are at higher risk for heart disease.

  • Desirable: Less than 200 mg/dL
  • Borderline high: 200-239 mg/dL
  • High: Over 240 mg/dL

Having a total cholesterol level over 240 mg/dL may double the risk of heart disease.

Low-density lipoprotein (LDL)

Low-density lipoprotein is bad cholesterol. Think of the “L” in LDL as “lousy.” High LDL levels increase the risk of heart disease.

Your actual LDL goal depends on whether or not you have existing risk factors for heart disease, such as diabetes or high blood pressure. But in general, LDL results are as follows:

  • Optimal: Less than 100 mg/dL
  • Near optimal: 100-129 mg/dL
  • Borderline high: 130-159 mg/dL
  • High: 160-189 mg/dL

your risk for heart disease, your doctor will discuss with you strategies for lowering your LDL by a certain percentage. Those strategies will include lifestyle changes — including dietary changes and exercise — as well as the use of cholesterol lowering medication. Together, you and your doctor will decide on the appropriate strategies for your particular situation.

High-Density Lipoprotein (HDL)

High-density lipoprotein (HDL) is good cholesterol. Think of the “H” in HDL as “healthy” to remember this cholesterol type as the good kind.

HDL helps carry bad cholesterol the bloodstream and arteries. It plays a very important role in preventing clogged arteries. So, the higher the HDL number, the better.

In general, HDL levels of 60 mg/dL or higher are considered to be good. wise, levels below 40 mg/dL are considered a risk factor for heart disease. But it's important to discuss with your doctor what level is best in your particular case.

Certain medications, including steroids, blood pressure drugs known as beta blockers, and some ‘water pills’ can interfere with HDL levels. Make sure your doctor always knows about all the medications you are taking.

Triglycerides

Triglycerides are a type of blood fat that has been linked to heart disease and diabetes. If you have high triglycerides, your total cholesterol and LDL levels may be high, as well.

  • Normal: less than 150 mg/dL
  • Borderline-High: 150-199 mg/dL
  • High: 200-499 mg/dL
  • Very High: 500 mg/dL

Lifestyle plays a large role in your triglyceride level. Smoking, excessive drinking, uncontrolled diabetes, and medications such as estrogen, steroids, and some acne treatments can contribute to high triglyceride levels. However, in some cases, genes or an underlying disease can be the cause.

Total Cholesterol to HDL Ratio

This number is not always listed on a cholesterol report. Some doctors use this instead of the total cholesterol level to help decide on an approach to lowering cholesterol. However, the American Heart Association recommends that focussing on actual values rather than ratios is more useful in determining treatment.

Very Low-Density Lipoprotein (VLDL)

This is a type of bad cholesterol that contains the highest amount of triglycerides. The higher your VLDL level, the more ly you are to have a heart attack or stroke.

The VLDL level is not always included in cholesterol reports. There is no simple or direct way to measure VLDL. Most labs estimate it by dividing the triglyceride level by 5. However, this is not valid if the triglyceride level is over 400.

Normal VLDL levels range from 5 – 40 mg/dL.

Keep in mind your cholesterol report offers a general guideline only. What's normal for you may not be OK for someone else. Your doctor will look at all your cholesterol numbers together with your other risk factors to develop a specific strategy for you.

Your goal depends on your age, family history of heart disease, and whether or not you have other risk factors for heart disease, such as diabetes, high blood pressure, and weight problems. Results may even vary depending on the lab a doctor uses. Always ask your doctor to help you interpret test results.

Adults aged 20 and older should have their cholesterol and triglyceride levels checked once every five years. However, your doctor may suggest doing this more often if you have certain risk factors such as diabetes, high blood pressure, obesity, or a family history of heart disease.

SOURCES:

Lab Tests Online: “Cholesterol: The Test.”

National Cholesterol Education Program: “High Blood Cholesterol, What You Need to Know.”

National Heart, Lung, and Blood Institute: “What is High Blood Cholesterol?”

American Heart Association: “What Your Cholesterol Levels Mean.”

© 2018 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/cholesterol-management/understanding-your-cholesterol-report

VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL

VLDL Cholesterol Levels, Blood Test + Ways to Lower VLDL

The effects of high VLDL cholesterol, how to best measure it and maintain healthy levels is still a hot topic of research. It is clear, though, that high VLDL is a major risk factor for heart disease and may contribute to chronic inflammation. Read on to learn more about VLDL-C and find out which lifestyle and dietary changes can help lower VLDL-C levels.

What Is VLDL Cholesterol?

VLDL-cholesterol (VLDL-C) is cholesterol bound to very-low-density lipoprotein (VLDL) particles. It transports triglycerides (fats) and cholesterol in the bloodstream [1].

Only a couple of decades ago, it was thought that high cholesterol in the blood was the main cause of heart disease. Now it is obvious that this picture is incomplete and that the levels of different particles that carry cholesterol in the body are more important than total cholesterol levels [2, 3].

There are several types of particles that carry cholesterol through the blood, such as VLDL, HDL, andLDL, each with different effects on the body and functions. These particles are all lipoproteins, made up of both fats (lipids) and proteins. Since fats do not easily dissolve in the blood, lipoproteins help to transport them [3, 4].

Lipoproteins are named according to their density and size. HDL stands for high-density lipoprotein and is the densest and smallest of the three.

LDL and VLDL stand forlow-density lipoprotein and very-low-density lipoprotein, respectively.

Cholesterol that is bound to these two types of lipoproteins is also referred to as “bad” cholesterol [3].

VLDL Function

VLDL is made in the liver after the body absorbs fat from dietary sources.

It transports triglycerides (with fatty acids) to the muscles and fat tissue, where they are deposited. In return, VLDL takes up cholesterol from the tissues.

As it loses triglycerides, VLDLbecomes LDL – a particle rich in cholesterol and low in triglycerides [4].

VLDL Negatives

Though VLDL is required by the body, high levels of VLDL may cause serious health problems [5].

The levels of VLDL are not the only thing that matters, however. The size and chemical makeup of VLDL particles also contribute to health risks [6, 7, 8, 9]:

  • Some VLDL particles are larger than others because they contain more fat.
  • The protein portion of VLDL may also become oxidized, which can cause oxidative damage to the inner lining of blood vessels, contributing to the formation of plaques in blood vessels.

VLDL-Cholesterol Blood Test

There is no simple test for directly measuring VLDL-C levels. Due to the complicated nature of the laboratory techniques needed to measure VLDL-C, its levels are estimated triglyceride levels found in the blood [10, 11].

The most widely used method for estimating VLDL-C is to divide the level of blood triglycerides by 5. This equation assumes that there is a fixed 5:1 ratio of triglycerides to VLDL particles.

This assumption is not always true because the actual ratio varies due to ethnicity, gender, and diet [11, 12, 13]. In addition, the calculation is not accurate when the triglyceride level is > 400 mg/dl (4.5 mmol/L).

In cases this, VLDL-C may be measured directly using specialized testing.

It is important to note that the level of VLDL-C alone is not the only factor that plays a role in heart disease. Other factors, such as the size and chemical makeup of VLDL-C, also play a role. Currently, there are no simple tests that account for these factors [6, 8].

Normal Range

Normal levels of VLDL-C are less than or equal to 30 mg/dl. High VLDL-C levels are above 30 mg/dl [14, 15]. Normal range may vary slightly between different laboratories.

Women produce fewer VLDL than men, resulting in lower overall VLDL-C levels [16, 14].

VLDL-C levels tend to rise in women following menopause. It is not clear if this increase in VLDL-C levels is due to the drop in hormones, increased body fat after menopause, or other factors [17].

Causes

Causes listed below are commonly associated with high VLDL-cholesterol levels. Work with your doctor or another health care professional to get an accurate diagnosis.

1) Carbs and Excess Calories

A study in postmenopausal women showed that diets high in carbs and low in fats can increase VLDL-C levels [18].

Diets high in carbs and calories in general increase the triglyceride and therefore VLDL-C levels [19, 20].

2) Sedentary Lifestyle

Being physically inactive i.e. a sedentary lifestyle increases triglyceride and therefore VLDL-C levels [21, 22, 23].

3) Obesity

About 50% of obese people have increased VLDL-C caused by increased production of VLDL by the liver, decreased removal of VLDL-C from the blood, or both [24].

In a study that compared 12 obese men and 12 lean men, the obese men had increased liver production of VLDL [25].

4) Insulin Resistance and Diabetes

Insulin lowers VLDL-C levels so when cells become resistant to insulin, they cannot properly lower VLDL-C [1, 26].

A study of 1,850 patients showed that people with greater insulin resistance had not only higher levels of VLDL-C but also produced larger, fattier VLDL particles. Studies in mice have also confirmed this [27, 28].

There’s a study that found that type-1 diabetes may not be associated with changes in VLDL-C levels in response to sugar. This suggests that only insulin resistance, characteristic of type-2 diabetes, adds to the risk of increased VLDL-C (a study of 8 men with type-1 diabetes) [29].

5) Hypothyroidism

In a study of 45 women, women with slightly lower thyroid function had higher levels of VLDL-C than women with normal thyroid function. Women with slightly higher thyroid function had lower levels of VLDL-C [30].

Another study of 113 patients, both male and female, confirmed that patients with slightly less active thyroid were more ly to have higher levels of VLDL-C and larger-sized VLDL [31].

6) Inflammation and Infection

Inflammation-promoting cytokines in Inflammation and infection increase VLDL production [32].

7) Chronic Kidney Disease

People with chronic kidney disease may produce VLDL-C at a normal rate but are less able to remove the VLDL-C from the blood [33].

8) Liver Disease

People with liver disease (e.g. fatty liver, cirrhosis) have higher triglyceride and VLDL-C levels [34, 35, 36].

9) Tobacco

Studies suggest that both smoking and chewing tobacco can increase VLDL-C and triglyceride levels [37, 38, 39].

10) Medication

Drugs that can increase VLDL-C levels include:

  • Glucocorticoids, such as prednisone [32, 40]
  • Water pills (diuretics) such as hydrochlorothiazide (Apo-hydro) [41]
  • Vitamin A derivative isotretinoin (Accutane) used to treat severe acne [42]
  • Second-generation antipsychotics such as clozapine (Clozaril, FazaClo, Versacloz) and risperidone ( Risperdal, Risperdal Consta) [43]

11) Genetic Disorders

Some rare genetic disorders (e.g. familial hypertriglyceridemia, familial combined hyperlipoproteinemia) cause an increase in VLDL-C [19].

1) Fatty Liver Disease

High VLDL levels can cause non-alcoholic fatty liver disease. Fat may build up in the liver when it is unable to move all the VLDL cholesterol to the blood. Reducing VLDL levels may reduce fat build-up fat in the liver, which may improve symptoms of fatty liver syndrome and diabetes [44, 45].

A study of 128 patients with fatty liver disease showed that the larger the VLDL particles a patient had, the more severe the disease was. Larger VLDL molecules can carry more fat than smaller ones. Another study of 25 obese people also showed that those with fat in their liver had increased production of VLDL [46, 47].

However, fatty liver disease can eventually cause liver damage that prevents the liver from producing VLDL, so VLDL-C levels may be lower in people with long-term fatty liver disease [27].

2) Clogged Arteries and Heart Disease

A study of over 30k people showed that those with high levels of VLDL-C (30 mg/dL or more) were 2-3 times more ly to develop heart disease [48].

When VLDL is broken down by the body, it is turned into byproducts that also contribute directly to the blocking of arteries. In addition, larger molecules of VLDL carry more fat that is then more ly to become stuck to the walls of the blood vessels. Therefore, lowering the size and levels of VLDL may protect against this effect [49, 50].

3) Type-2 Diabetes

Metabolic syndrome is a cluster of conditions that occur together, including high blood pressure, high cholesterol and triglycerides, abdominal obesity, and high blood sugar.

Metabolic syndrome is marked by insulin resistance and often leads to type-2 diabetes. People withlarge VLDL particles, but small LDL and HDL, had the worst symptoms of metabolic syndrome, and a higher risk of developing type-2 diabetes (study with 1,036 people) [51].

Increased VLDL-C levels occurred before the development of type-2 diabetes in patients with metabolic syndrome, suggesting that high VLDL-C may contribute to this progression [52].

4) High Blood Pressure

VLDL stimulates the production of aldosterone, a hormone that causes the body to hold on to salt, leading to increased blood pressure [53, 54, 55].

Obesity often leads to high blood pressure, which may be caused by high levels of VLDL-C. Lowering VLDL-C levels may reduce obesity-related high blood pressure [56].

Decreasing VLDL-C

The most important thing is to work with your doctor to find out what’s causing your high VLDL-C levels and to treat any underlying conditions.

Depending on your medical history and other test results, your doctor may prescribe a cholesterol-lowering medication.

Discuss the additional lifestyle changes listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes!

Because of the relationship between VLDL and triglycerides, you can lower your VLDL cholesterol level by taking steps to lower your triglyceride level. These include making healthy lifestyle changes, such as losing excess weight and exercising regularly. It has also been advised to avoid sugary foods and alcohol in particular since these have a strong effect on triglycerides.

1) Exercise

Exercise regularly. Aerobic exercise, such as running, swimming, or cycling, for over 30 minutes several times a week can help lower your triglyceride and VLDL-C levels [19, 57, 58, 59].

2) Weight Loss

Lose weight if overweight. Losing weight can help decrease your triglyceride and VLDL-C levels [19, 60].

3) Healthy Diet

The following dietary changes can help reduce VLDL-C levels:

  • Avoid overeating in general. Eat less of sugary and processed foods and minimize your intake of saturated and trans fats [18, 19, 20].
  • Eat more fiber-rich foods, such as fruits and vegetables [61].
  • A Mediterranean diet is a good example of a diet that can help lower your triglyceride and VLDL-C levels and decrease your risk of heart disease. This type of diet includes lots of fruits and vegetables, fatty fish, olive oil, and nuts [62, 63, 64, 65].
  • Increase your consumption of fatty omega-3 rich fish [66].

4) Avoiding Alcohol

Lower your alcohol consumption or refrain from drinking altogether. Alcohol can increase triglyceride and VLDL-C levels [19, 67].

5) Quitting Smoking

Quit smoking. Tobacco increases VLDL-C [37, 38, 39].

6) Supplements

Discuss the following foods and supplements with your doctor. Research has shown they can help decrease triglyceride and therefore VLDL-C levels:

Lipases

Lipases are a group of enzymes that help to break down VLDL. A mutation in the lipoprotein lipase gene has been associated with larger VLDL particles in people with metabolic syndrome. Other mutations in this gene result in low levels of the lipoprotein lipase protein and higher VLDL [83, 84].

People with another common mutation in the hepatic lipase gene have increased VLDL levels and a reduced ability to control VLDL levels after exercise [85].

Apolipoprotein E (ApoE)

ApoE is a protein found in VLDL molecules. As a result of mutations in the gene that encodes the protein, different versions exist. A version known as ApoE4 is found to produce more inflammation in the blood vessels after meals than the normal version, ApoE3 [86, 87].

Having a defective copy of ApoE contributes to high VLDL levels, but this factor alone does not significantly raise VLDL levels [88].

Source: https://selfhacked.com/blog/vldl-cholesterol-levels/

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