Background and aims: Plasma apolipoprotein C3 (ApoC3) is associated with higher plasma triglyceride and type 2 diabetes incidence. We evaluated whether body mass index (BMI) or glucose metabolism were associated with ApoC3 in healthy monozygotic (MZ) twins. Methods and Results: Forty-seven MZ twin-pairs (20 man, 27 women), aged 23e42 years, were divided in subgroups according to discordance or concordance for (a) BMI (within-pair difference (D) in BMI!3.0 or<3.0 kg/m 2 ), or (b) 2-h glucose iAUC, during oral glucose tolerance test (DGlucose iAUC !97.5 or<97.5 mmol  120 minutes). Within these discordant or concordant subgroups, we tested (Wilcoxon signed-rank test) co-twin differences in ApoC3, adiposity measures, insulin-resistance and beta-cell function indices, and plasma and lipoprotein lipids.In BMI-Discordant (p Z 0.92) or BMI-Concordant (p Z 0.99) subgroups, ApoC3 did not differ between leaner and heavier co-twins. In the GlucoseeDiscordant subgroup, ApoC3 was significantly higher in twins with higher Glucose iAUC than in their co-twins with the lower Glucose iAUC (10.03 AE 0.78 vs. 8.48 AE 0.52 mg/dl; M AE SE; p Z 0.032). Co-twins with higher Glucose iAUC also had higher waist circumference, body fat percentage, liver fat content, worse insulin-sensitivity and beta-cell function and higher cholesterol and triglyceride in plasma VLDL, IDL, and LDL. In GlucoseeConcordant twin-pairs, no significant differences were observed in the explored variables. In all twin-pairs, DApoC3 correlated with D in lipids and glucose metabolism variables, the closest relationship being between DApoC3 and DVLDL triglyceride (r Z 0.74, p < 0.0001). Conclusions: While ApoC3 was not related to acquired differences in BMI, it associated with early dysregulation of glucose metabolism independently of obesity and genetic background.