Normal triglyceride levels despite insulin resistance in African Americans: role of lipoprotein lipase

Sumner, Anne E.; Vega, Gloria Lena; Genovese, David J.; Finley, Karl B.; Bergman, Richard N.; Boston, Raymond C.

doi:10.1016/j.metabol.2005.03.001

Cited by 95 publications

(99 citation statements)

References 29 publications

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“…43 In addition, even though insulin resistance should impair LPL activity, 44 we have previously shown that LPL activity does not decline in insulin-resistant African Americans. 45 …”

Section: Discussionmentioning

confidence: 99%

Triglyceride-Based Screening Tests Fail to Recognize Cardiometabolic Disease in African Immigrant and African-American Men

Ramsey²,

Castillo³

et al. 2013

Metabolic Syndrome and Related Disorders

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Background: The prevalence of cardiometabolic disease in Africa now rivals that of Western nations. Therefore, screening programs that lead to effective prevention of cardiometabolic disease in Africans is imperative. Most screening tests for cardiometabolic disease use triglyceride (TG) levels as a criterion. However, the failure rate of TG-based screening tests in African Americans is high. In Africans, the efficacy of TG-based screening tests is unknown. Our goal was to determine the association between hypertriglyceridemia (TG ‡ 150 mg/dL) and cardiometabolic disease in African and African-American men. Research Design and Methods: This was a cross-sectional study of 155 men (80 African immigrants, 75 African Americans) [age, 35 -9 years, mean -standard deviation (SD), body mass index (BMI) 28.5 -5.2 kg/m 2 ] who self-identified as healthy. Lipid profiles were performed. Glucose tolerance and insulin resistance was determined by oral glucose tolerance tests (OGTT) and the insulin sensitivity index (S I ), respectively. Cardiometabolic disease was defined by four possible subtypes-prediabetes, diabetes, insulin resistance, or metabolic triad [hyperinsulinemia, hyperapolipoprotein B, small low-density lipoprotein (LDL) particles]. Results: TG levels were higher in men with cardiometabolic disease than without (88 -43 versus 61 -26 mg/dL, P < 0.01). However, < 10% of men with cardiometabolic disease had TG ‡ 150 mg/dL. Even within each cardiometabolic disease subtype, the prevalence of TG ‡ 150 mg/dL was < 10%. Furthermore, TG levels in the 5% of men identified by OGTT as diabetic were £ 100 mg/dL (mean 71 -24, range 45-100 mg/dL). Conclusions: Hypertriglyceridemia is a poor marker of cardiometabolic disease in men of African descent. Therefore TG-based screening tests fail to identify both African immigrants and African-American men with cardiometabolic disease. As a consequence, the opportunity for early intervention and prevention is lost.

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“…43 In addition, even though insulin resistance should impair LPL activity, 44 we have previously shown that LPL activity does not decline in insulin-resistant African Americans. 45 …”

Section: Discussionmentioning

confidence: 99%

Triglyceride-Based Screening Tests Fail to Recognize Cardiometabolic Disease in African Immigrant and African-American Men

Ramsey²,

Castillo³

et al. 2013

Metabolic Syndrome and Related Disorders

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“…This finding seems to corroborate indirectly the findings of the Triglyceride and Cardiovascular Risk in African American (TARA) Study of the National Institutes of Health, which reported that insulinresistant African-American subjects do not demonstrate impairment of postheparin-lipoprotein lipase activity commonly seen with insulin resistance in other ethnic groups. This impairment is inversely associated with serum triglyceride concentration (26). A low frequency of impairment of postheparin-lipoprotein lipase in African Americans with metabolic syndrome (and presumed insulin resistance) would help explain why triglyceride levels remain low, even in a population with high rates of depressed HDL cholesterol levels.…”

Section: Prevalence Of Metabolic Syndromementioning

confidence: 99%

“…This finding suggests that applying a uniform cut point for both groups for triglyceride and HDL cholesterol concentrations may result in significant misclassification (36). Adjustment of cut point values (using CVD incidence data by triglyceride and HDL concentrations) or measures of lipoprotein subclass profiles (e.g., VLDL, small LDL, and HDL particle concentrations) may provide better estimates of lipid-related metabolic risk in African Americans than sole use of the lipid criteria from the NCEP ATP III (26). However, our data affirm that abdominal obesity, elevated blood pressure, and low HDL cholesterol concentration are key components of metabolic syndrome in the African-American population.…”

Section: Limitations Of Studymentioning

confidence: 99%

Distinct Component Profiles and High Risk Among African Americans With Metabolic Syndrome

et al. 2008

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OBJECTIVE -Health of African Americans is seriously threatened by unremitting epidemics of diabetes and cardiovascular disease (CVD). However, the role of metabolic syndrome in the African-American population has not been investigated widely. This study examined the prevalence of metabolic syndrome and assessed its cross-sectional relationship to CVD in the Jackson Heart Study (JHS) cohort.RESEARCH DESIGN AND METHODS -A total of 5,302 participants aged Ն21 years who were recruited at baseline during 2000 -2004 were analyzed for this study. Adjusted odds ratios (ORs) were estimated in a logistic regression analysis for coronary heart disease (CHD) and cerebrovascular disease (CBD) in those with and without coexisting metabolic syndrome. Diabetic participants were excluded.RESULTS -Among those aged 35-84 years, metabolic syndrome prevalence was 43.3% in women and 32.7% in men. Elevated blood pressure (70.4%), abdominal obesity (64.6%), and low HDL cholesterol (37.2%) were highly prevalent among those with metabolic syndrome. Prevalence rates for CVD, CHD, and CBD were 12.8, 8.7, and 5.8%, respectively. After adjustment for age and sex, metabolic syndrome was associated with increased age-and sex-adjusted ORs for CVD (OR 1.7 [95% CI 1.4 -2.1]), CHD (1.7 [1.4 -2.2]), and CBD (1.7 [1.3-2.3]) compared with those without CVD, CHD, or CBD.CONCLUSION -Metabolic syndrome prevalence in the JHS is among the highest reported for population-based cohorts worldwide and is significantly associated with increased ORs for CVD, CHD, and CBD. Abdominal obesity, increased blood pressure, and low HDL cholesterol (without triglyceride elevation) are surprisingly prominent. A high prevalence of low HDL emerges as a leading contributor to metabolic syndrome among African Americans in this large African-American cohort.

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“…There is evidence that the difference in HDL-C between African-American and White men may be due to a relatively lower hepatic lipase activity in African-Americans (Vega GL 1998). The difference in TG may be related to increased activity of lipoprotein lipase in African-Americans (Sumner AE 2005). However, compared with Whites, Hispanics and Asians, African-Americans have less favorable levels of lipoprotein(a) (Lp[a]), which is structurally similar to LDL-C, with an additional disulfide linked glycoprotein termed ApoA.…”

Section: Ethnic Differences In Lipid Profiles In General Populationsmentioning

confidence: 99%

Ethnic Difference in Lipid Profiles

Zhang¹,

Qiao²,

Dong³

2012

Dyslipidemia - From Prevention to Treatment

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Normal triglyceride levels despite insulin resistance in African Americans: role of lipoprotein lipase

Cited by 95 publications

References 29 publications

Triglyceride-Based Screening Tests Fail to Recognize Cardiometabolic Disease in African Immigrant and African-American Men

Triglyceride-Based Screening Tests Fail to Recognize Cardiometabolic Disease in African Immigrant and African-American Men

Distinct Component Profiles and High Risk Among African Americans With Metabolic Syndrome

Ethnic Difference in Lipid Profiles

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