Very low-density lipoprotein (VLDL)cholesterol

VLDL – Very low-density lipoproteins) – role in the body, norms and deviations

VLDL (VLDL) is a particle synthesized in the liver that transports triglycerides (TG) from the liver to tissues. They play a key role in fat metabolism, but their excess contributes to the development of atherosclerosis.

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VLDL functions in the body

1. Triglyceride Transport -VLDL delivers TG to muscle (for energy) and adipose tissue (for storage).
2. Precursor of LDL (‘bad cholesterol’) – after the release of triglycerides, VLDL is converted to LDL.
3. Participation in metabolism – when VLDL breaks down, free fatty acids are released, which are used as an energy source.

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Norm of VLDL in the blood

Direct measurement of VLDL is difficult, so their level is usually calculated by triglycerides:
VLDL (mmol / L) = TG ÷ 2.2

• Normal level: 0.26-1.04 mmol / L (or 10-40 mg / dl)
• Borderline: 1.04-1.5 mmol / l
• High: >1.5 mmol / l (increases the risk of atherosclerosis)

Note: In some laboratories, VLDL is not indicated separately, but is evaluated by the level of triglycerides (norm: <1.7 mmol/l).

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Causes and consequences of elevated VLDL

Causes of ↑ VLDL:

• Obesity and metabolic syndrome – excess fat in food.
• Type 2 diabetes mellitus -insulin resistance increases the synthesis of TG.
• Hypothyroidism – slowing down of lipid metabolism.
• Chronic kidney disease is a violation of fat excretion.
• Genetic disorders (familial hypertriglyceridemia).
• Alcoholism -increases the production of TG in the liver.
• Taking medications (corticosteroids, retinoids, beta blockers).

Symptoms and complications:

• Atherosclerosis – VLDL penetrates the walls of blood vessels, forming plaques.
• Pancreatitis – with a very high level of TG (>5.6 mmol / l).
• Fatty liver disease– due to the accumulation of TG.
• Xanthomas are fat deposits on the skin (eyelids, elbows).

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Low VLDL: causes and consequences

Causes of ↓ VLDL:

• Fasting or an extremely low-fat diet.
• Hyperthyroidism – accelerated fat metabolism.
• Taking statins and fibrates.
• Rare genetic diseases (abetalipoproteinemia).

Symptoms:

• Energy depletion – lack of triglycerides to nourish the muscles.
• Deficiency of fat-soluble vitamins (A, D, E, K) – because VLDL is involved in their transport.

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Diagnosis and treatment

Analyzes:

1. Lipidogram -includes: VLDL (or calculated by TG), LDL, HDL, total cholesterol.
2. Additionally:

• Blood glucose (exclude diabetes).
• TSH (check the thyroid gland).
• Liver tests (ALT, AST).

Treatment for high VLDL:

• Diet: Limit sugar, alcohol, and trans fats. Increased fiber (vegetables, oatmeal).
• Medication:
• Fibrates (Fenofibrate) – reduce TG by 30-50%.
• Omega-3 (EPA/DHA) – in high doses (2-4 g / day).
• Statins – if LDL is also elevated.
• Physical activity – 150 min / week (walking, swimming).

With low VLDL:

• Nutrition correction (healthy fats: nuts, avocados, fish).
• Treatment of the underlying disease (for example, hyperthyroidism).

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Examples of indicators

VLDL Level	Interpretation
<0.78 mmol/L	Normal
0.78–1.04 mmol/L	Borderline
>1.04 mmol/L	High Risk of Atherosclerosis

Important: VLDL is not the only marker of risk. Evaluate the entire lipid profile (LDL, HDL) along with the clinical picture.