Bharadwaj A, Taneja M, Dubey S, Saxena A. Very low-density lipoprotein and the human health. World J Exp Med 2026; 16(1): 117024 [PMID: 41883448 DOI: 10.5493/wjem.v16.i1.117024]
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Alok Bharadwaj, Manas Taneja, Sneha Dubey, Aditya Saxena. Very low-density lipoprotein and the human health. World J Exp Med 2026;16(1): 117024 [DOI: 10.5493/wjem.v16.i1.117024]
Abstract
Apo B100, TGL and cholesterol are present in LDL in addition to VLDL. But the ratio of TGL: cholesterol may vary.
PATHOLOGICAL ROLE OF VLDL:
Metabolism-associated fatty liver disease and liver disease:
Distinction between NAFLD, MAFLD and MASLD may be provided
Following the classification of metabolic dysfunction-associated fatty liver disease (MAFLD), non-alcoholic fatty liver disease (NAFLD) has recently been redefined again as metabolic dysfunction-associated steatotic liver disease (MASLD). Both MASLD and MALFD were linked to higher all-cause mortality risk, but MASLD identified a greater number of individuals compared to MAFLD. (Song R, Li Z, Zhang Y, Tan J, Chen Z. Comparison of NAFLD, MAFLD and MASLD characteristics and mortality outcomes in United States adults. Liver Int. 2024;44:1051-1060. doi:10.1111/liv.15856)
Metabolic-associated fatty liver disease (MAFLD) exhibits a raised VLDL secretion rate attributed to increased intrahepatic TGs hydrolysis. They apparent the absence of immediate VLDL secretion reduction yet maintained a consistent apo B100 secretion rate, as informed by previous studies/
I would like to reframe this sentence: in the presence of elevated counter-regulatory hormones, lipolysis takes place in the adipose tissue releasing free fatty acids into circulation. Majority of these fatty acids are take up liver and converted into triglycerides. If VLDL secretion from liver is not proportionate to the level of fatty acid entry into liver, fatty acids may get accumulated in the liver causing different forms of fatty liver.
In individuals with insulin resistance and higher body weight, there is an elevation in apo C-III levels within VLDL.
Apo CIII is an inhibitor of lipoprotein lipase, thus inhibiting lipolysis of TGL in VLDL, thus increasing VLDL concentration in blood.
Insulin resistance and MetS
Insulin-hampered VLDL production, along with insulin resistance, leads to increased and decreased production of VLDL, often associated with hypertriglyceridemia
Does VLDL increase or decrease with insulin resistance
Hepatic VLDL production is decreased by glucagon
Mechanism behind this
Alterations of VLDL in various disorders have been explained well.
All the mechanistic pathways have been adequately addressed