In the latest issue of Current Opinion in Lipidology, Khosrow Adeli and Gary F. Lewis reviewed the current understanding of the link between insulin resistance and intestinal lipoprotein overproduction by summarizing the literature on the topic and highlighting some key recent findings. The authors suggested that pathways linking insulin resistance and overproduction of intestine-derived lipoproteins should also include elevated free fatty acid flux into the intestine, the downregulation of the intestinal signalling pathway, and the upregulation the microsomal triglyceride transfer protein, all of which are found in individuals with insulin resistance. The authors also drew attention to the role of specific gut peptides such as glucagon-like peptides 1 and 2, which have been highlighted recently, noting that these peptides are important regulators of intestinal lipid absorption and lipoprotein production. Lastly, Adeli and Lewis raised numerous questions regarding the overproduction of intestinal lipoproteins in insulin resistance and type 2 diabetes and suggested that their relevance in the pathophysiology of diabetes merits further study.
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