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Background  African-Americans are more insulin-resistant than whites but have lower triglyceride (TG) concentrations. The metabolic basis for this is unknown. Our goal was to determine in a cross-sectional study the effect of insulin resistance, visceral adipose tissue (VAT) and the apolipoproteins, B, C-III and E, on race differences in TG content of very low density lipoproteins (VLDL).    Methods  The participants were 31 women (16 African-American, 15 white) of similar age (37 ± 9 vs. 38 ± 11y (mean ± SD),  P =  0.72) and BMI (32.4 ± 7.2 vs. 29.3 ± 6.0 kg/m 2 ,  P =  0.21). A standard diet (33% fat, 52% carbohydrate, 15% protein) was given for 7 days followed by a test meal (40% fat, 40% carbohydrate, 20% protein) on Day 8. Insulin sensitivity index (S I ) was calculated from the minimal model. VAT was measured at L2-3. The influence of race, S I , VAT and apolipoproteins on the TG content of VLDL was determined by random effects models (REM).    Results  African-Americans were more insulin-resistant (S I : 3.6 ± 1.3 vs. 5.6 ± 2.6 mU/L -1 .min -1 ,  P  < 0.01) with less VAT (75 ± 59 vs. 102 ± 71 cm 2 ,  P  < 0.01). TG, apoB and apoC-III content of light and dense VLDL were lower in African-Americans (all  P  < 0.05 except for apoC-III in light VLDL,  P =  0.11). ApoE content did not vary by race. In REM, VAT but not S I  influenced the TG concentration of VLDL. In models with race, S I , VAT and all apolipoproteins entered, race was not significant but apoC-III and VAT remained significant determinants of TG concentration in light and dense VLDL.    Conclusions  Low concentrations of apoC-III and VAT in African-Americans contribute to race differences in TG concentrations.    Trial registration  ClinicalTrials.gov Identifier:  NCT00484861

ApoC-III and visceral adipose tissue contribute to paradoxically normal triglyceride levels in insulin-resistant African-American women