Apolipoprotein A-V (apoA-V) is a recently discovered apolipoprotein that appears to have a role in plasma triglyceride (TG) transport. We have developed an ELISA for apoA-V using monoclonal antibodies that has a lower limit of detection of 0.3 ng/ml and linearity up to 20 ng/ml. The ELISA was then used to quantify plasma apoA-V in 196 healthy subjects and 106 patients with insulin-resistant diabetes mellitus. In the healthy subjects, total apoA-V concentration was 179.2 ؎ 74.8 ng/ml, and it was greater in females than in males ( P Ͻ 0.005). It was correlated positively with the plasma HDL cholesterol ( r ؍ 0.32, P Ͻ 0.0001), apoA-I ( r ؍ 0.27, P ؍ 0.0001), and apoE ( r ؍ 0.18, P ؍ 0.011) concentrations and negatively with plasma TG concentration ( r ؍ ؊ 0.22, P ؍ 0.021). In relation to single nucleotide polymorphism 3 ( ؊ 1131C/T) of the apoA-V gene, apoA-V concentration was higher in the T/T type than in the C/C type ( P Ͻ 0.01). Plasma TG concentration was lower in the T/T type than in the C/C or C/T type ( P Ͻ 0.05). ApoA-V concentration was lower in the diabetic patients (69.4 ؎ 44.3 ng/ml; P Ͻ 0.01) than in the healthy controls. Plasma triglyceride (TG) levels are influenced by both genetic and environmental factors and are a major independent risk factor for coronary heart disease (1, 2). Plasma TG concentration is influenced by many factors. These include apolipoproteins A-I, A-IV, C-II, and C-III, LPL, LCAT, cholesteryl ester transfer protein, and phospholipid transfer protein (3-11). These factors and their associated gene-environment interactions are of importance in the pathogenesis of coronary heart disease.Apolipoprotein A-V (apoA-V) has recently been identified by comparative sequencing of human and mouse DNA and is located ف 27 kb distal to the apoA-IV gene in the APOA1/C3/A4 gene cluster on chromosome 11q23 (12). ApoA-V, shown to be expressed mostly in liver and independently named regeneration-associated protein 3, is upregulated after the early phase of liver regeneration after hepatectomy in rat (13). In mice overexpressing the human apoA-V gene, TG concentrations decreased by 50-70%, and in apoA-V gene knockout mice, plasma TG concentrations increased ف 4-fold (12-14). These results suggest that apoA-V expression may strongly influence, and be negatively associated with, plasma TG concentrations. ApoA-V both enhances lipoprotein lipase-mediated hydrolysis of plasma TG and inhibits hepatic VLDL-TG production (15). ApoA-V also stimulates the efflux of cholesterol from cells by a mechanism independent on the ABCA1 protein, as do other exchangeable apolipoproteins, such as apoA-I and apoA-IV (16). It was recently described that apoA-V mRNA is regulated by peroxisome proliferator-activated receptor ␣ agonists (17,18) and that the liver X receptor ligand T0901317 decreases apoA-V mRNA through the activation of sterol-regulatory element binding protein 1c (SREBP-1c) (19). These results raise the possibility that some TG-lowering agents, such as fenofibrate, may act by alte...