BetaVLDL

BetaVLDL, or beta-lipoprotein, is a fraction of very-low-density lipoprotein (VLDL) that migrates to the beta region during electrophoretic separation. It is described as a remnant lipoprotein enriched in cholesterol and cholesterol esters and containing apolipoprotein B-100.

Formation and metabolism: The liver synthesizes VLDL, which delivers triglycerides to tissues. Lipoprotein lipase-mediated lipolysis converts VLDL to intermediate-density lipoprotein (IDL) and then to LDL. In some individuals, cholesterol-rich remnants that retain beta mobility accumulate, particularly in dyslipoproteinemia type III (dysbetalipoproteinemia), due to impaired remnant clearance often linked to ApoE isoforms such as ApoE2. BetaVLDL remnants tend to be relatively cholesterol-rich and triglyceride-poor compared with the parent VLDL particle.

Clinical significance: BetaVLDL is a characteristic finding in type III hyperlipoproteinemia and is associated with elevated risk of premature atherosclerotic disease. Patients typically show increased total cholesterol and elevated remnants on lipoprotein profiling, with a distinctive beta-lipoprotein band on electrophoresis that reflects remnant particles.

Diagnosis and laboratory methods: BetaVLDL can be identified by lipoprotein electrophoresis or ultracentrifugation and is supported by apolipoprotein B-100 measurement and ApoE genotyping when dysbetalipoproteinemia is suspected. Remnant particle assays and apolipoprotein profiling may aid assessment of remnant-rich lipoproteins.

Management: Treatment focuses on managing dyslipidemia and reducing cardiovascular risk. Options include statins or fibrates, dietary modification, weight management, physical activity, and control of contributing conditions such as diabetes. Family screening and genetic counseling may be considered in suspected dysbetalipoproteinemia.