Hypertriglyceridemia but not diabetes status is associated with VLDL containing apolipoprotein CIII in patients with coronary heart disease.

High apoCIII concentration in apoB lipoproteins is a prominent component of atherogenic dyslipidemia, and explains the risk of coronary heart disease (CHD) associated with high triglyceride (TG). We hypothesized that diabetic people have atherogenic dyslipidemia with apoCIII in excess of that accounted for by their high TG levels. We selected 30 diabetic and 30 nondiabetic persons, 15 of each with fasting TG<160 mg/dl and 15 with TG>/=200 mg/dl. Using immunoaffinity chromatography and ultracentrifugation, we prepared large and small VLDL, IDL and LDL with or without apoCIII or apoE. The groups with TG>/=200 mg/dl, regardless of diabetes status, had higher concentrations of large and small VLDL particles with apoCIII and higher apoCIII concentrations than the groups with fasting TG<160 mg/dl. The diabetes groups did not have higher concentrations of these lipoproteins than the nondiabetes groups within the same fasting TG criteria. In conclusion, high concentrations of apoCIII-containing VLDL are associated with hypertriglyceridemia, which may play a critical role in identifying the high risk of CHD in hypertriglyceridemic patients whether diabetic or nondiabetic. Diabetes status per se does not appear to be associated with high concentrations of apoCIII-containing TG-rich lipoprotein particles, if the plasma TG levels are similar.