VLDL Cholesterol

VLDL (very low-density lipoprotein) cholesterol can lead to build up in arteries that contribute to clogging of the arteries, known as atherosclerosis. The amount of VLDL cholesterol in blood can help doctors evaluate a patient’s risk of heart disease and stroke.

A VLDL cholesterol test uses a blood sample. There is no way to measure VLDL cholesterol itself. Instead, the amount of VLDL cholesterol is estimated based on triglyceride levels taken during a triglyceride test or a lipid panel.

Cholesterol is a waxy substance that helps with normal cell function. Cholesterol is carried in the blood throughout the body by a combination of fat and protein called lipoproteins. Different kinds of lipoproteins carry cholesterol through the blood including high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL). This test estimates the level of VLDL in the blood.

Some cholesterols, like LDL and VLDL, can lead to a buildup of fatty deposits, called plaques, in the arteries, leading to a clogging of the arteries and a condition known as atherosclerosis. This plaque build up can increase one’s risk of heart disease, stroke, and other conditions.

Purpose of the test

A VLDL cholesterol test helps assess the risk of heart disease, stroke, heart attack, and other cardiovascular conditions. Estimating VLDL cholesterol in blood as part of a triglyceride test or lipid panel can help doctors with screening, monitoring, and diagnosing heart and vascular health issues.

• Screening: Screening tests try to find health problems before symptoms arise. Your doctor may order a test to check VLDL cholesterol levels as part of early detection of potential cardiovascular problems.
• Diagnosis: Diagnostic tests are a way for your doctor to determine what may be causing health changes and symptoms. Calculating your VLDL cholesterol can help your doctor understand if your health issue may be caused by a heart or vascular problem. Knowing your VLDL cholesterol levels can also help your doctor suggest appropriate lifestyle changes or treatment.
• Monitoring: Monitoring involves follow-up tests to check to see how your condition changes over time or in response to treatment.

What does the test measure?

A VLDL cholesterol test reports an estimate of the amount of VLDL cholesterol in your blood. VLDL cholesterol is not directly measured. Instead, it is calculated using a specific equation based on triglyceride levels. In other words, the VLDL cholesterol test actually measures triglycerides in order to estimate the level of VLDL cholesterol.

The amount of VLDL cholesterol in the blood is usually measured in milligrams per deciliter (mg/dL). In many cases, the test will also provide the levels of other types of cholesterol in your blood.

When should I get a VLDL cholesterol test?

Recommendations for when to be tested for VLDL cholesterol depend on a number of factors including your age, any family history of high cholesterol (including high cholesterol leading to heart disease, stroke, or other health issues), and other risk factors.

It is helpful to talk with your doctor about your personal health history and your family history to decide when cholesterol testing is appropriate for you. Here is a general guide for when cholesterol testing may be recommended:

Many initial cholesterol tests do not include VLDL cholesterol. However, your doctor may choose to have VLDL cholesterol calculated to obtain more information about your specific cholesterol levels.

Most laboratories that perform cholesterol and triglyceride testing are able to report a VLDL cholesterol value. While some at-home testing is available, typically VLDL levels are not reported through these solutions. Instead, your doctor will typically order the VLDL level as part of an evaluation of other cholesterols and/or triglycerides.

How to get tested

Your doctor or another health professional may order a test that includes your VLDL cholesterol level. There is no direct way to measure VLDL cholesterol, so it is usually calculated based on triglyceride levels. The test is done by drawing a sample of blood at a doctor’s office or other medical facility such as a medical clinic, laboratory, or hospital. The sample is then sent to a laboratory to be analyzed.

Can I take the test at home?

While there are some at-home cholesterol tests that measure different types of cholesterol, it is rare for these tests to calculate VLDL cholesterol.

How much does the test cost?

The cost of a VLDL cholesterol test can depend on several factors including insurance coverage and where the test is being performed.

When ordered by a health professional, cholesterol testing is usually covered by insurance, but there can be out-of-pocket costs such as copays, deductibles, or fees charged by the lab technician that draws your blood.

A blood sample is needed to perform a test for VLDL cholesterol. A medical professional or lab technician will draw a blood sample from a vein in your arm. The blood sample is then analyzed by a laboratory.

Before the test

You may be asked to fast before having a VLDL cholesterol test. This means that you may be asked not to eat or drink for 9-12 hours before testing. Testing is often scheduled for early in the morning so that you will be fasting while you sleep.

You can usually drink water while fasting, but you will want to check with your doctor for any special instructions you may need before testing.

During the test

Testing for VLDL cholesterol requires drawing a sample of blood in a common procedure called a venipuncture.

Before the procedure, an elastic band may be tied around your upper arm, causing the veins in your arm to swell. This will make it easier for the person drawing your blood to find a vein.

Before the needle is inserted, an antiseptic wipe will be used to disinfect the skin near your vein. Once the needle is inserted, blood will flow through the needle and be collected in an attached test tube or vial.

During the test, you may feel a slight sting or pain. The entire test lasts only a few minutes.

After the test

After your blood sample is drawn, the needle will be removed from your arm, and the area will be covered with a band-aid or other dressing to help stop the bleeding.

There is little risk from a blood test to check for VLDL cholesterol. You may notice some minor pain or bruising where your blood was drawn, but this usually goes away quickly.

Receiving test results

The results of your test are usually ready within a few days. You may receive your results through an online health portal or in the mail. Your doctor may contact you to talk with you about your test results and to discuss if any follow-up is needed.

Interpreting test results

VLDL cholesterol is reported in milligrams per deciliter of blood (mg/dL). Your report will show your VLDL cholesterol level and the reference range for normal VLDL cholesterol.

Reference ranges can vary by laboratory, but normal VLDL cholesterol is typically between 2 and 30 mg/dl. A level higher than 30 mg/dL may put you at an increased risk for cardiovascular disease.

Because there is no direct test measuring VLDL cholesterol, VLDL cholesterol is estimated using your triglyceride level. As a result, you may see triglycerides listed on your test report. Generally, VLDL cholesterol is calculated as about one-fifth of your triglyceride level.

It is important to be aware that VLDL cholesterol calculations are not as accurate in patients with a triglyceride level over 400 mg/dL. If you have very high triglycerides, the doctor may choose to order a direct LDL cholesterol test that can help assess your levels of the “bad” type of cholesterol that can increase risk of heart disease and other cardiovascular events.

If you had a lipid panel or other broader cholesterol tests, you may also see your levels of total cholesterol, HDL cholesterol, and/or LDL cholesterol on your test report.

Your doctor can talk more with you about your test results and what they mean for your health. VLDL cholesterol is just one type of cholesterol. Doctors more often focus on high levels of LDL cholesterol when considering the need for treatment to reduce cardiovascular risk. Doctors also consider things such as your age, sex, lifestyle habits like smoking, family history, and overall health when interpreting your results.

If you are determined to have an elevated risk of heart disease or other conditions, your doctor may suggest taking steps to improve your cardiovascular health.

Questions for your doctor about test results

Your doctor is in the best position to answer questions about your VLDL cholesterol level and what the results of your test mean for your health. These are some questions you can ask to get detailed information about your VLDL cholesterol results:

• What is my VLDL cholesterol level?
• Did you measure other types of cholesterol? If so, what were the results?
• Do I have risk factors for cardiovascular disease?
• Do you recommend I have another cholesterol test? If so, when?
• Are there any other tests needed to evaluate my cardiovascular health?
• What are the next steps in my care? Do I need to make any lifestyle changes or take any medications to reduce my risk of developing heart disease or other health conditions?