A high ratio is linked to abnormal lipid metabolism and increased risk of CVD events.

When the VLDL-C/TG ratio is > 0.30 it indicates the presence of cholesterol-rich chylomicron and VLDL remnant lipoproteins, which increase CVD risk.

A VLDL-C/TG ratio of > 0.30 has been associated with an increased risk of CVD and dysbetalipoproteinemia often associated with the apoE2/2 genotype.

Potential treatment options:

- Lifestyle modification

- Statins

- Niacin

- Fibrates

- Cholesterol absorption inhibitors

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Therapeutic lifestyle change is the cornerstone for reducing risk for Cardiovascular Disease (CVD) and diabetes. The following recommendations are based on the American Heart Association's dietary and lifestyle guidelines.

Consume a dietary pattern that achieves ≤6% of calories from saturated fat and emphasizes intake of vegetables, fruits and whole grains; includes low-fat dairy products, poultry, fatty fish, legumes, non-tropical vegetable oils and nuts; and limits intake of refined grains, sweets, sugar-sweetened beverages and red meats. Eliminate foods high in trans fat.

If indicated: control blood pressure, reduce weight, engage in smoking cessation and be physically active — work up to getting at least 30 minutes of a moderate intensity physical activity, at least 5 days per week.

→ Elevated production markers indicate an increased cellular production of cholesterol which may be associated with obesity and metabolic syndrome. Therapeutic lifestyle changes focus on LDL-C reduction through weight loss and decreased intake of animal fat, refined carbohydrates, sweets and sugar-sweetened beverages.

→ To increase HDL-C and to decrease non-HDL-C, LDL-C levels it is important to reduce saturated fat intake, refined carbohydrates, sugars and eliminate trans fats.

→ To lower small dense LDL-C reduce intake of simple carbohydrates and alcohol and if indicated reduce weight and increase physical activity. An elevation in small dense LDL-C is often associated with metabolic syndrome.

→ To optimize glucose, HbA1c, HOMA-IR, and reduce risk of diabetes and CVD it is important to reduce weight and simple carbohydrate intake. 

→ Uric acid is the end product of purine metabolism and is commonly associated with metabolic syndrome. Stay well hydrated and consider reducing high fructose corn syrup, alcohol and purines in the diet.