Large VLDL Particle Number
The number of large, triglyceride-rich VLDL particles in your blood. It tends to follow your triglycerides and is a main input to the LP-IR score.
AI-verified against cited sources. Awaiting expert reviewAlso called Large VLDL-PLOINC 43728-5
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What it is
VLDL particles are made by your liver and carry mostly triglycerides, a type of blood fat. NMR tests sort them by size, and large VLDL are the biggest, most triglyceride-rich group. Labcorp reports the count in nanomoles per liter (nmol/L) on its NMR LipoProfile that includes insulin-resistance markers. The count tends to rise when your triglycerides rise.
Why it matters
Large VLDL particles are one of the two most heavily weighted inputs to Labcorp's LP-IR score, an index of insulin resistance. In a large US study (MESA), people with more large VLDL particles were more likely to develop type 2 diabetes in the following years, even after accounting for blood sugar, insulin and HOMA-IR. A 2026 Circulation review says the current ACC/AHA guideline recommends against NMR particle testing beyond a standard lipid panel, apoB and Lp(a). So this number is best read as a clue about metabolic health, next to your triglycerides, blood sugar and other results.
If it’s low
A low count is the direction Labcorp's scale treats as more insulin sensitive. It usually goes with low triglycerides and is not a concern on its own.
Common causes
- Low triglycerides
- Good insulin sensitivity
- Fasting before the test
If it’s high
A higher count means more large, triglyceride-rich particles are circulating. It often goes with high triglycerides and insulin resistance. Many everyday things raise it, including a recent meal, alcohol and extra sugar. A high result is not a diagnosis. Your clinician can look at it with your triglycerides, blood sugar and other results.
Common causes
- Eating shortly before the blood draw (a non-fasting sample)
- Alcohol, especially heavy drinking
- A diet high in sugar and refined carbohydrates
- Extra weight, belly fat or little physical activity
- Insulin resistance, prediabetes or poorly controlled type 2 diabetes
- Thyroid, liver or kidney conditions
- Some medicines
- Inherited conditions that raise triglycerides
What can help
- Fast for the time your lab asks, so a recent meal doesn't push the count up
- Cut back on alcohol and sugary drinks, and eat less added sugar and refined carbohydrate
- If you carry extra weight, losing some of it can lower triglycerides
- Be active most days
- Ask your clinician whether a blood sugar test such as fasting glucose or A1c is worth checking
- Ask your clinician whether any of your medicines can raise triglycerides
Usual ranges
What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.
For adults: up to 2.7 nmol/L. Source: Labcorp.
- Adults (this one applies)up to 2.7 nmol/L
Source: Labcorp
What can affect your result
- Fasting: eating before the test can raise the count
- Alcohol in the day before the test
- Triglycerides, insulin resistance, diabetes and body weight
- Diet, especially sugar and refined carbohydrates
- Thyroid, liver and kidney conditions, and some medicines
- Method: labs group VLDL particles by size differently, so counts and ranges differ between methods
- Eating raises triglyceride-rich particles. Labcorp asks for an 8-hour fast and says its LP-IR score is inaccurate on a non-fasting sample. Mayo Clinic Laboratories asks for 12 hours of fasting for its NMR profile, and Quest's NMR test asks for 12 hours.
- Mayo also asks for no alcohol for 24 hours before the draw for its NMR profile.
- A sample taken soon after a fatty meal can read high, because the particles carry the fat from that meal.
- Labcorp rejects samples that are grossly hemolyzed, contaminated with red cells, or held too long at room temperature.
Often within a few weeks of changes in diet, alcohol, weight or medicine, following your triglycerides.
When to talk to a clinician
Large VLDL on its own is not an emergency value. Talk with a clinician if your result is above your lab's range, especially if your triglycerides are 150 mg/dL (1.7 mmol/L) or higher and you also have diabetes, extra weight or a family history of early heart disease. Triglycerides of 500 mg/dL (5.7 mmol/L) or more call for closer attention because they raise the chance of pancreatitis, so mention that to your clinician soon rather than waiting for a routine visit. If you have chest pain or pressure, trouble breathing, or signs of a stroke such as face drooping, arm weakness or trouble speaking, call 911 or your local emergency number, whatever your results are.
Questions you could ask
- Is this test useful for me, or would my triglycerides and standard lipid panel tell us what we need?
- Could a recent meal, alcohol or my weight explain a high count?
- Should we check my blood sugar or A1c?
- Would you like me to repeat the test after fasting?
Questions people ask
Why does Labcorp ask me to fast for this test?
Large VLDL particles carry triglycerides, and a recent meal raises them. Labcorp asks for an 8-hour fast, and it says the LP-IR score from this panel is inaccurate on a non-fasting sample.
Is large VLDL the same as my triglycerides?
No, but they are closely related. Triglycerides measure the fat carried by all particles, and large VLDL-P counts only the largest triglyceride-rich particles. The count tends to rise when triglycerides rise.
Show the science and sources
For clinicians and researchers
Large VLDL-P is the molar concentration of VLDL particles in the largest NMR size class. In the LipoProfile-3 algorithm used in the LP-IR publication, large VLDL-P is defined as particles above 60 nm. Labcorp prints nmol/L with a reference of 2.7 nmol/L or less, the median of its 4,588-person LipoScience reference group (25th and 75th percentiles 0.9 and 6.9 nmol/L). In the original LP-IR algorithm, large VLDL-P carries 22 of 100 points, second only to VLDL size (32), and the score caps the weight of large VLDL-P and VLDL size to limit the effect of genetic hypertriglyceridemia that is not tied to insulin resistance. Large VLDL-P correlated with HOMA-IR at r = 0.45 in MESA and with glucose disposal rate at r = -0.39. In MESA (5,314 adults), higher large VLDL-P, VLDL size and LP-IR were associated with incident type 2 diabetes independent of established risk factors, glucose, insulin and HOMA-IR. A 2026 Circulation review states that the current ACC/AHA guideline recommends against NMR and other advanced lipoprotein testing beyond the lipid panel, apoB and Lp(a), and notes triglycerides of 150 mg/dL or more as a risk enhancer and 500 mg/dL or more as severe hypertriglyceridemia with pancreatitis risk. Labcorp's test is a laboratory-developed test that the FDA has not cleared or approved.
LOINC 43728-5 (primary). Specimen: serum-or-plasma.
Sources
- NMR LipoProfile+IR+Graph, sample patient report (test 123497), Labcorp (2024)
- NMR LipoProfile With Insulin Resistance Markers, Without Lipids (With Graph) (test 123497), Labcorp
- Nuclear Magnetic Resonance Lipoprotein Profile, Serum (test NMRLP), Mayo Clinic Laboratories (testcatalog.org)
- Lipoprotein Fractionation, NMR (test 37847), Quest Diagnostics
- Lipoprotein insulin resistance index: a lipoprotein particle-derived measure of insulin resistance, Metabolic Syndrome and Related Disorders (2014)
- Lipoprotein particles and incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis, Diabetes Care (2015)
- Lipid Profile Testing and Interpretation (summarizes the 2026 ACC/AHA Dyslipidemia Guideline), Circulation (Nguyen, Ahmad, Navar) (2026)
- Triglycerides, MedlinePlus (National Library of Medicine)
AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.