Abstract

Objective: To examine gender specific black/white differences in lipoprotein profile and the role of visceral adiposity, and to assess the relationship between insulin sensitivity and lipoprotein profiles in each group.

Research Design and Methods: Fasting lipoprotein particle size and concentration and visceral adipose tissue (VAT) were determined in 226 children (117 black, 101 male) aged 8-<18 years. The relationship between lipoproteins and insulin sensitivity was evaluated in a subset of 194 children (100 black, 88 male) who underwent a hyperinsulinemic-euglycemic clamp.

Results: Black males had smaller very low density lipoprotein (VLDL) and black females had larger high density lipoprotein (HDL) size than their white counterparts. Overall, blacks had larger low density lipoprotein (LDL) with no gender-specific race differences. After adjusting for VAT and gender, only VLDL size and concentrations remained significantly favorable in blacks. Analysis of lipoprotein particle size and concentration across insulin sensitivity quartiles revealed that in both racial groups, the most insulin resistant children had higher concentrations of small dense LDL, small HDL, large VLDL, and smaller LDL and HDL sizes than their more insulin sensitive counterparts.

Conclusions: The previously reported favorable lipoprotein profiles in black vs white children is partly due to race differences in VAT. In both groups however, the most insulin resistant youths have a high risk atherogenic profile of small dense LDL, small HDL and large VLDL, akin to the atherogenic lipoprotein pattern in adults with coronary artery disease.