Rationale: Although lipids, apolipoproteins, and lipoprotein particles are important modulators of inflammation, varying relationships exist between these parameters and asthma.Objectives: To determine whether serum lipids and apolipoproteins correlate with the severity of airflow obstruction in subjects with atopy and asthma.Methods: Serum samples were obtained from 154 atopic and nonatopic subjects without asthma, and 159 subjects with atopy and asthma. Serum lipid and lipoprotein levels were quantified using standard diagnostic assays and nuclear magnetic resonance (NMR) spectroscopy. Airflow obstruction was assessed by FEV 1 % predicted.Measurements and Main Results: Serum lipid levels correlated with FEV 1 only in the subjects with atopy and asthma. Serum levels of high-density lipoprotein (HDL) cholesterol and apolipoprotein A-I (apoA-I) were positively correlated with FEV 1 in subjects with atopy and asthma, whereas a negative correlation existed between FEV 1 and serum levels of triglycerides, low-density lipoprotein (LDL) cholesterol, apolipoprotein B (apoB), and the apoB/apoA-I ratio. NMR spectroscopy identified a positive correlation between FEV 1 and HDL NMR particle size, as well as the concentrations of large HDL NMR particles and total IDL NMR (intermediate-density lipoprotein) particles in subjects with atopy and asthma. In contrast, LDL NMR particle size and concentrations of LDL NMR and VLDL NMR (very-low-density lipoprotein) particles were negatively correlated with FEV 1 in subjects with atopy and asthma.Conclusions: In subjects with atopy and asthma, serum levels of apoA-I and large HDL NMR particles are positively correlated with FEV 1 , whereas serum triglycerides, LDL cholesterol, and apoB are associated with more severe airflow obstruction. These results may facilitate future studies to assess whether apoA-I and large HDL NMR particles can reduce airflow obstruction and disease severity in asthma.