LAUSR

Despite higher rates of obesity, insulin resistance, and type 2 diabetes mellitus, women of African descent, irrespective of geographic location, have consistently been shown to have lower fasting triglyceride concentrations than their European counterparts.1–4 This is described as the triglyceride paradox and emphasises the point that risk prediction using algorithms devised in European populations may not be suitable for populations of African descent. Notably, many studies in populations of African ancestry have shown that triglycerides and the triglyceride/HDL-cholesterol ratio are not markers of insulin resistance in African populations.4,5 As the risk for type 2 diabetes mellitus and cardiovascular disease is still high in African populations, it is essential to gain an understanding of the underlying mechanisms involved in the dissociative relationship between triglycerides and insulin resistance. This information will not only inform risk prediction but also add to our understanding of the pathogenesis of type 2 diabetes mellitus and cardiovascular disease, and hence guide future interventions to reduce the risk of these noncommunicable diseases in African populations.