Characterization of the Metabolic Syndrome by Apolipoproteins in the Oklahoma Cherokee

Native Americans are susceptible to type 2 diabetes and associated cardiovascular risk that precedes the diabetes. Nondiabetic Cherokee adolescents and young adults were studied for association of apolipoproteins A-I, B, and C-III with the metabolic syndrome, homeostasis model assessment–insulin resistance (HOMA-IR), and body mass index. Apolipoproteins, lipids, selected ratios, and HOMA-IR changed adversely according to the number of metabolic syndrome criteria present (P<.001 for trend). Logistic regression showed heparin-precipitated apolipoprotein C-III, apolipoprotein C-III bound to apolipoprotein B–containing lipoproteins, to be a significant predictor of the metabolic syndrome in the adolescents and adults, and it appears to be more strongly associated than apolipoprotein B: apolipoprotein A-I. Regression modeling with components of the syndrome as the dependent variables showed that they were all significantly associated with heparin-precipitated apolipoprotein C-III except for fasting blood glucose. The Cherokee have a high prevalence of the metabolic syndrome, which is associated with atherosclerotic lipoprotein particles containing apolipoprotein C-III and B.