Intestinal lipid absorption and transport in type 2 diabetes – published online 30/07/2022

Bruno Vergès

The intestine plays an important role in the dyslipidaemia observed in type 2 diabetes and particularly in postprandial hyperlipidaemia, which is known to promote atherosclerosis and increase the incidence of cardiovascular disease. In this issue, Bruno Vergès (https://doi.org/10.1007/s00125-022-05765-8) reviews disorders of intestinal lipid metabolism in type 2 diabetes, which include increased chylomicron production by enterocytes and delayed catabolism of chylomicrons and chylomicron remnants. He outlines how overproduction of chylomicrons is secondary to increased expression of microsomal triglyceride transfer proteins, higher stability and availability of apolipoprotein B-48 and increased de novo lipogenesis. He goes on to discuss how reduced activity of lipoprotein lipase is a major factor responsible for reduced catabolism of chylomicrons in type 2 diabetes. Interestingly, some glucose-lowering treatments significantly influence intestinal lipid metabolism, particularly glucagon-like peptide-1 agonists. Vergès concludes that a better understanding of intestinal lipid metabolism should help to define interesting therapeutic targets for improving postprandial lipid metabolism in type 2 diabetes. The figures from this review are available as a downloadable slideset.

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