Also Known As
VLDL-C
VLDL
Formal Name
Very Low-Density Lipoprotein Cholesterol
This article was last reviewed on
This article waslast modified on
May 25, 2018.
At a Glance
Why Get Tested?

To help assess the risk of developing heart disease

When To Get Tested?

When other lipid tests, such as a lipid profile, are being performed

Sample Required?

A blood sample drawn from a vein in your arm or a fingerstick

Test Preparation Needed?

Usually fasting for 9-12 hours before the test (only water permitted) and no alcohol for 24 hours before the test; follow any instructions you are given.

You may be able to find your test results on your laboratory's website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your lab's website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab's website or portal, or contact your healthcare practitioner in order to obtain your test results.

Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.

The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.

If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.

Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called "normal" values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.

While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

For more information, please read the article Reference Ranges and What They Mean.

What is being tested?

Very low-density lipoprotein (VLDL) is one of the four major lipoprotein particles. The other three are high-density lipoprotein (HDL), low-density lipoprotein (LDL), and chylomicrons. Each particle contains a mixture of cholesterol, triglyceride, and protein, but in varying amounts unique to each type of particle. LDL contains the highest amount of cholesterol. HDL contains the highest amount of protein. VLDL and chylomicrons contain the highest amount of triglyceride.

VLDL particles are released into the blood by the liver and circulate in the bloodstream, ultimately being converted into LDL as they lose triglyceride, having carried it to other parts of the body. According to the National Heart, Lung and Blood Institute's National Cholesterol Education Program Guidelines ATP III, there is growing evidence that VLDL plays an important role in atherogenesis, in which plaques form on the interior walls of arteries, narrowing these passageways and restricting blood flow, which can lead to heart disease and increase the risk of stroke.

At present there is no simple, direct way of measuring VLDL cholesterol. However, since VLDL-C contains most of the circulating triglyceride (if a person is fasting) and since the composition of the different particles is relatively constant, it is possible to estimate the amount of VLDL-C based on the triglyceride value.

To estimate VLDL-C, divide the triglyceride value by 5 if the value is in mg/dL or divide by 2.2 if the value is in mmol/L. This estimate is used in most settings. The calculation is not valid, however, when the triglyceride level is greater than 400 mg/dl (4.5 mmol/L) because other lipoproteins are usually present. Triglycerides testing most often requires that the patient fast before sample collection; otherwise these calculations may be invalid.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm. Sometimes a drop of blood is collected by puncturing the skin on a fingertip.

Is any test preparation needed to ensure the quality of the sample?

Since VLDL-C is usually calculated from the triglyceride level, preparation is the same as for the triglyceride test. Current recommendations for this testing include fasting (having nothing to eat or drink except water) for 9 to 12 hours beforehand and avoiding alcohol consumption for at least 24 hours before the test. Follow any instructions you are given.

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Common Questions
  • How is it used?

    Very low-density lipoprotein cholesterol (VLDL-C) may be reported as part of a lipid profile, a group of tests that are often ordered together to determine risk of coronary heart disease and an important part of cardiac risk assessments.

    Increased levels of VLDL-C are thought to reflect the presence of particles called lipoprotein remnants that are intermediate particles on the pathway of conversion of VLDL to LDL. When high levels of VLDL are present, the conversion of VLDL to LDL is slowed and the accumulation of intermediate particles is thought to contribute to the development of atherosclerosis and coronary heart disease.

  • When is it ordered?

    VLDL-C is generally not ordered as a separate test. It may be reported with the results of a lipid profile when a health practitioner wants to determine a person's risk of heart disease.

  • What does the test result mean?

    An elevated level of VLDL cholesterol (>30 mg/dL or >0.77 mmol/L), like elevated LDL cholesterol, is considered a risk factor for heart disease and stroke. The presence of high VLDL in addition to high LDL may affect the choice of therapy used to lower a person's cholesterol, such as lifestyle changes or drug treatment.

    Low levels of VLDL cholesterol are not generally a concern.

  • Is there anything else I should know?

    VLDL cholesterol concentrations, like all lipoprotein fractions, can be measured directly using techniques such as lipoprotein electrophoresis and ultracentrifugation. However, these techniques are complex and expensive and are not usually done in clinical laboratories. These tests are generally carried out in specialty laboratories, most often for research purposes.

  • How can I lower my VLDL-C level?

    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. Cholesterol-lowering medication may also be recommended. Talk to your health care provider about what is right for you.

Related Content

On This Site

Tests: Lipid Profile; Cardiac Risk Assessment; Triglycerides; LDL Particle Testing

Conditions: Heart Disease, Stroke

Elsewhere On The Web

MayoClinic.com: VLDL cholesterol: Is it harmful?  
MedlinePlus Medical Encyclopedia: Understanding cholesterol results 

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View Sources

Sources Used in Current Review

MayoClinic.com. VLDL cholesterol: Is it harmful? Available online at http://www.mayoclinic.com/health/vldl-cholesterol/AN01335 through http://www.mayoclinic.com. Accessed September 2013.

MedlinePlus Medical Encyclopedia. VLDL test. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003494.htm. Accessed September 2013.

Sources Used in Previous Reviews

MedlinePlus Medical Encyclopedia: VLDL Test. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003494.htm. Accessed May 2010.

National Heart, Lung and Blood Institute. National Cholesterol Education Program Guidelines, Cholesterol, ATP III. Pp 31-34. PDF available for download at http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf through http://www.nhlbi.nih.gov. Accessed May 2010.

OhioHealthOnline. VLDL cholesterol: What is it? Available online at http://www.ohiohealth.com/bodymayo.cfm?xyzpdqabc=0&id=6&action=detail&ref=2755 through http://www.ohiohealth.com. Accessed May 2010.

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