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"Half the dsylipidemia of insulin resistance" is the dyslipidemia [corrected] of insulin-resistant Blacks.

Even though the dyslipidemia of insulin resistance is characterized by increased triglyceride (TG) and low high density lipoprotein-cholesterol (HDL-C) levels, insulin-resistant Blacks usually have normal TG levels.1,2 Therefore, the universality of the concept of the dyslipidemia of insulin resistance needs re-examination. Overall, a lack of appreciation of the absence of hypertriglyceridemia in insulin-resistant Blacks has lead to the development of health screening programs that are not optimally effective in Blacks. For example, paradigms used to identify individuals at risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) often require that TG be elevated.3 Therefore, these programs often lead to the under-diagnosis of risk of T2DM and CVD in Blacks.4 As the dyslipidemia of insulin resistance, particularly elevated TG, is part of many screening programs,3,5–13 we need to critically review the effectiveness of these programs in Blacks. 
 
The observation that Blacks often have only “half the dyslipidemia of insulin resistance” (ie, normal TG and low HDL-C levels) challenges established dogma that in the presence of insulin resistance, increased TG and low HDL-C are a couplet.14 To understand the physiology of insulin resistance, pathways that allow “half the dyslipidemia of insulin resistance” to occur in Blacks must be explored. 
 
In this commentary, syndromes that emphasize elevated TG to predict risk for T2DM and CVD are identified and their effectiveness in Black populations examined. Then pathways that could account for the finding of “half the dyslipidemia of insulin resistance” in Blacks are described.