Heart and vessels
VLDL Lipoproteïne
The fat particles that carry triglycerides from the liver; largely follows the triglyceride level.
Everything about this testWhat it measures
Fats travel through the blood in small spheres called lipoproteins. VLDL (very low density lipoprotein) is made in the liver and mainly carries triglycerides to muscles and fatty tissue. Along the way it releases triglycerides and becomes smaller, until it eventually turns into LDL. Most laboratories do not measure VLDL directly but estimate the VLDL cholesterol from the triglyceride level; some laboratories measure the particles with a separate separation method.
- A raised level of triglyceride-rich fat particles, such as with overweight, diabetes or a lot of alcohol
- Rarely: a hereditary disorder of fat metabolism
High
A raised value almost always goes together with raised triglycerides. That usually fits overweight, too little exercise, a diet high in sugar and fast carbohydrates, alcohol use, poorly controlled diabetes or an underactive thyroid. Having blood drawn without fasting also raises the value. VLDL particles and their remnants contribute to hardening of the arteries; non-HDL cholesterol, the measure of risk in the Dutch GP guideline (NHG) on cardiovascular risk management, already includes VLDL cholesterol. A raised value causes no symptoms itself.
Low
A low value fits low triglycerides and is usually favorable. Rarely, a very low value occurs with malnutrition, an overactive thyroid, a severe liver disease or a rare hereditary disorder. A low value causes no symptoms itself.
Preparation
- Fasting is not required, but it gives the most accurate result: in that case do not eat for 12 hours before the sample is taken and drink only water. If the result is very high, have the test repeated while fasting.
- Do not drink alcohol the day before the sample is taken, because alcohol raises triglycerides.
If your result is abnormal
With a raised value, the GP looks at the triglycerides, non-HDL cholesterol, blood sugar, thyroid and lifestyle, and repeats the measurement fasting if needed. With an increased risk of cardiovascular disease, the approach follows the Dutch GP guideline (NHG) on cardiovascular risk management; with very high triglycerides, referral to an internist (specialist in internal medicine) sometimes follows.
Reliability
If VLDL cholesterol is estimated from the triglycerides, the value adds nothing to the triglyceride level itself. A direct measurement also mainly gives a picture of the triglyceride-rich particles. There are no agreed target values for VLDL; the risk estimate in the Dutch GP guideline (NHG) on cardiovascular risk management uses non-HDL cholesterol, in which VLDL cholesterol is already included. According to the Dutch Society for Clinical Chemistry (NVKC), the way lipoprotein particle testing is carried out differs per laboratory, and it gives at most an indication of the chance of cardiovascular disease.
Limitations
- Food and alcohol in the hours before the blood draw raise the value; the result is best interpreted with a fasting blood draw.
- An estimate from the triglycerides is unreliable with very high triglycerides.
- Methods differ per laboratory: an estimate and a direct measurement are not readily comparable.
- An underactive thyroid, diabetes, kidney diseases and some medicines (including estrogens, corticosteroids and beta blockers) raise the value.
How common is this
Raised triglycerides, and with them a raised VLDL, are common, especially with overweight, diabetes and alcohol use. Cardiovascular disease is one of the main causes of death in the Netherlands. Dutch figures on a raised VLDL as a separate finding are lacking.
Who is this useful for
The result is mainly informative together with the full cholesterol panel, with raised triglycerides or when a hereditary disorder of fat metabolism is suspected. For estimating the risk of cardiovascular disease, non-HDL cholesterol, LDL cholesterol and the other risk factors say more than the VLDL value alone.
Downsides and risks
- A rise due to having blood drawn without fasting can cause unnecessary worry or lead to unnecessary further testing.
Sources
Always discuss an abnormal result with your GP. If a result is strongly abnormal, we try to reach you as soon as possible. Read your result yourself as well and contact your GP if in doubt. A test does not make a diagnosis. Read more about risks and results