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Persons with type 2 diabetes mellitus (T2DM) have an elevated risk of atherosclerosis. High‐density lipoproteins (HDL) normally protect against cardiovascular disease (CVD), but this may be attenuated by serum amyloid A (SAA). In a case‐control study of young females, blood samples were compared between subjects with T2DM (n = 42) and individuals without T2DM (n = 42). SAA and apolipoprotein AI (apoAI) concentrations, paraoxonase‐1 (PON‐1), cholesteryl ester transfer protein (CETP), and lecithin‐cholesterol acyltransferase (LCAT) activities were measured in the serum and/or HDL₂ and HDL₃ subfractions. SAA concentrations were higher in T2DM compared to controls: serum (30 mg/L (17, 68) versus 15 mg/L (7, 36); p = 0.002), HDL₂ (1.0 mg/L (0.6, 2.2) versus 0.4 mg/L (0.2, 0.7); p < 0.001), and HDL₃ (13 mg/L (8, 29) versus 6 mg/L (3, 13); p < 0.001). Serum‐PON‐1 activity was lower in T2DM …