This article is available online at http://www.jlr.orgThe insulin-resistance state and type 2 diabetes mellitus (T2DM) are closely related with an increase in cardiovascular disease. Factors conditioning this increase in cardiovascular disease include metabolic dyslipidemia associated with insulin resistance. It has recently been suggested that the overproduction of intestinally derived apolipoprotein (apo)B48-containing lipoproteins may contribute greatly to the dyslipidemia found in both the fasting and postprandial states in insulin resistance ( 1-3 ). However, the underlying mechanisms are still not fully understood.Most studies undertaken in this area have been carried out in the postprandial state ( 3, 4 ). The intestine maintains a basal production of apoB48, even in fasting states, synthesizing small triglyceride-rich lipoprotein (TRL) particles ( 4, 5 ). Animal studies have shown that the contribution of intestinal lipoproteins to the total fasting plasma triglycerides is from 10% to 20% ( 4, 5 ), increasing in the case of diabetes ( 4, 6, 7 ). Fructose-fed hamsters experience an increase in the assembly and secretion of apoB48-containing lipoproteins in insulin-resistant states ( 2 ). Duez et al. showed that the production of chylomicrons (CM) was upregulated in humans with insulin resistance ( 8 ). Studies undertaken in fructose-fed, insulin-resistant Syrian golden hamsters in both the fasted and fed states found that, in these insulin-resistant animals, the increased production of small TRL was greater in the fasted state than the fed state ( 1 ). Nevertheless, caution should be exercised when extrapolating results from experimental animal models to humans, due to the differences between species.Abstract The overproduction of intestinal lipoproteins may contribute to the dyslipidemia found in diabetes. We studied the infl uence of diabetes on the fasting jejunal lipid content and its association with plasma lipids and the expression of genes involved in the synthesis and secretion of these lipoproteins. The study was undertaken in 27 morbidly obese persons, 12 of whom had type 2 diabetes mellitus (T2DM). The morbidly obese persons with diabetes had higher levels of chylomicron (CM) triglycerides ( P < 0.001) and apolipoprotein (apo)B48 ( P = 0.012). The jejunum samples obtained from the subjects with diabetes had a lower jejunal triglyceride content ( P = 0.012) and angiopoietin-like protein 4 (ANGPTL4) mRNA expression ( P = 0.043). However, the apoA-IV mRNA expression was signifi cantly greater ( P = 0.036). The jejunal triglyceride content correlated negatively with apoA-IV mRNA expression ( r = Ű 0.587, P = 0.027). The variables that explained the jejunal triglyceride content in a multiple linear regression model were the insulin resistance state and the apoA-IV mRNA expression. Our results show that the morbidly obese subjects with diabetes had lower jejunal lipid content and that this correlated negatively with apoA-IV mRNA expression. These fi ndings show that the jejunum appears to play an act...