Muniyappa R, Sachdev V, Sidenko S, Ricks M, Castillo DC, Courville AB, Sumner AE. Postprandial endothelial function does not differ in women by race: an insulin resistance paradox? Am J Physiol Endocrinol Metab 302: E218 -E225, 2012. First published November 1, 2011; doi:10.1152/ajpendo.00434.2011.-Insulin resistance is associated with endothelial dysfunction. Because AfricanAmerican women are more insulin-resistant than white women, it is assumed that African-American women have impaired endothelial function. However, racial differences in postprandial endothelial function have not been examined. In this study, we test the hypothesis that African-American women have impaired postprandial endothelial function compared with white women. Postprandial endothelial function following a breakfast (20% protein, 40% fat, and 40% carbohydrate) was evaluated in 36 (18 AfricanAmerican women, 18 white women) age-and body mass index (BMI)-matched (age: 37 Ϯ 11 yr; BMI: 30 Ϯ 6 kg/m 2 ) women. Endothelial function, defined by percent change in brachial artery flow-mediated dilation (FMD), was measured at 0, 2, 4, and 6 h following a meal. There were no significant differences between the groups in baseline FMD, total body fat, abdominal visceral fat, and fasting levels of glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, or serum estradiol. Although AfricanAmerican women were less insulin-sensitive [insulin sensitivity index (mean Ϯ SD): 3.6 Ϯ 1.5 vs. 5.2 Ϯ 2.6, P ϭ 0.02], both fasting triglyceride (TG: 56 Ϯ 37 vs. 97 Ϯ 49 mg/dl, P ϭ 0.007) and incremental TG area under the curve (AUC0 -6hr: 279 Ϯ 190 vs. 492 Ϯ 255 mg·dl Ϫ1 ·min Ϫ1 ·10 Ϫ2 , P ϭ 0.008) were lower in African-American than white women. Breakfast was associated with a significant increase in FMD in whites and African-Americans, and there was no significant difference in postprandial FMD between the groups (P Ͼ 0.1 for group ϫ time interactions). Despite being insulin-resistant, postprandial endothelial function in African-American women was comparable to white women. These results imply that insulin sensitivity may not be an important determinant of racial differences in endothelial function.African Americans; endothelial function AFRICAN-AMERICAN WOMEN SUFFER disproportionately from greater cardiovascular (CV) morbidity and mortality when compared with white women (15). In addition to differences in cultural issues, socioeconomic status, and access to health care, traditional cardiometabolic risk factors such as hypertension, diabetes, obesity, smoking, and physical inactivity disproportionately affecting African-American women contribute to the increased cardiovascular disease (CVD) risk (1, 15). Insulin resistance is independently related to cardiac and vascular function and augments CVD risk in African Americans with hypertension (13). Because African-American women are insulin-resistant compared with white women, they are highly susceptible to develop CVD.Endothelial dysfunction characterized by reduced nitric oxide (NO)-dependent vasc...