we studied 98 male subjects aged 5070 years with the metabolic syndrome ( defined using international diabetes federation criteria ) . exclusion criteria were the presence of type 2 diabetes , overt cardiovascular disease , use of statins or fibrates , and a bmi > 40 kg / m . plasma concentrations of apoci and apociii were determined using sandwich enzyme - linked immunosorbent assays specific for human apoci and apociii ( 8) . magnetic resonance imaging ( mri ) , measuring sat and vat area at the level of the intervertebral disk level between the fourth and fifth lumbar vertebra , was performed on a 3 t scanner ( philips ; achieva , best , the netherlands ) as described previously ( 9 ) . to address the question whether high apoci , high apociii , and the combination of high apoci and apociii are associated with increased tg concentrations and decreased vat and sat area , the study subjects were divided into groups according to median apoci concentration ( 6.38 mg / dl ; skewed distribution ) and mean apociii concentration ( 10.2 mg / dl ; normal distribution ) . differences in clinical and laboratory parameters and sat and vat area were assessed by independent t test or one - way anova , with post hoc least significant difference testing , if appropriate . mann - whitney tests or kruskall - wallis tests ( followed by mann - whitney tests , p values were multiplied by three to correct for multiple testing ) were performed for parameters that were not normally distributed . clinical and laboratory parameters , including waist circumference and homeostasis model assessment , were not different between the four groups , apart from hdl cholesterol , total cholesterol , and smoking ( see table a1a in the online appendix available at http://dx.doi.org/10.2337/dc08-1330 ) . there were more smokers in the group with high apociii compared with low apociii ( 33 and 7% , respectively ; p < 0.01 ) . apoci and apociii levels were positively correlated (  = 0.405 , p < 0.001 ) . tg concentrations were 49% higher in subjects with both high apoci and apociii compared with subjects with low apoci and apociii ( p < 0.001 ) ( fig . subjects with both high apoci and apociii had 26% decreased vat area ( p < 0.001 ) and 7% lower sat area ( not significant ) compared with subjects with both low apoci and apociii levels ( fig . subjects with apoci above the median had 16% lower vat area ( p < 0.05 ) and 3% higher sat area ( not significant ) . subjects with apociii above the median had 18% lower vat area ( p < 0.01 ) and 14% lower sat area ( not significant ) . to exclude the difference in smoking frequency as a possible confounder tg levels were slightly lower , but for both tg and vat area , the results remained highly significant ( online appendix table a1b ) . high apoci and apociii concentrations are associated with increased tg concentrations and decreased vat area in men with the metabolic syndrome . the phenotypic appearances caused by modulation of apoci and apociii may be very relevant for human subjects with the metabolic syndrome , since visceral obesity and increased tg levels are two of its main characteristics ( 7 ) . in addition , intra - abdominal fat is presumed to be an important determinant of metabolic dysregulation ( 10,11 ) . the data presented in this study are in line with experimental data and indicate that the mechanisms uncovered by these experimental studies can be translated to the human situation . to be more precise , these data suggest that the known inhibition of lpl by apoci and apociii contributes to higher tg and lower vat area in human subjects . furthermore , the difference in effect of apoci and apociii on tg concentrations observed in this study underlines the stronger inhibition of lpl by apociii compared with apoci , as shown in experimental studies ( 2 ) . this can be related to a higher expression of lpl in vat versus sat , as evident from experimental studies in mice ( 6 ) . alternatively , lpl may be differently regulated in various fat depositions ( e.g. , vat vs. sat ) . this adds to the discussion relating lpl to fat deposition , since studies comparing lpl mass , activity , and mrna expression between subcutaneous and visceral fat have shown contradictory results ( 10,12,13 ) . the difference in smoking frequency has not confounded our results , because when the analysis was repeated after exclusion of smokers , almost identical results were obtained . the current observations are restricted to male , abdominally obese subjects , aged 5070 years , without type 2 diabetes or cardiovascular disease . nevertheless , this study shows that in men with the metabolic syndrome , high apoci and apociii levels are associated with increased tg levels and decreased visceral fat mass , which is in line with in vivo data from mouse models . this study is the first to address the effect of lpl regulation on adipose tissue deposition in humans and necessitates further studies on the effect of lpl , the lpl coactivator apocii , and their polymorphisms on adipose tissue mass .
objective  to determine whether , in accordance with observations in mouse models , high concentrations of the lipoprotein lipase inhibitors apolipoprotein ( apo ) ci and apociii are associated with increased triglyceride concentrations and decreased fat mass in men with the metabolic syndrome.research design and methods  plasma apoci , apociii , and triglyceride concentrations were measured in the postabsorptive state in 98 men with the metabolic syndrome . 
 subcutaneous and visceral fat areas were measured by 3t - magnetic resonance imaging.resultstriglyceride concentrations were 49% higher , and the average visceral fat area was 26% lower ( both p < 0.001 ) , in subjects with high apoci and apociii compared with low apoci and apociii . 
 subjects with either high apoci or apociii had 16% ( p < 0.05 ) and 18% ( p 
 < 0.01 ) decreased visceral fat area , respectively.conclusionshigh concentrations of apoci and apociii are associated with increased triglycerides and decreased visceral fat mass in men with the metabolic syndrome . 
 these findings translate mouse studies into human pathophysiology .