This article is available online at http://www.jlr.org progression and increased severity of diabetic complications. The dysregulation of hepatic VLDL secretion is believed to be the mechanism underlying increases in TG-related VLDL and is responsible for the pathogenesis of hepatic insulin resistance in type 2 diabetes, representing a principal target for clinical intervention.Fenofi brate, a fi brate-derived drug, was widely used in the treatment of dyslipidemia in diabetic patients for decades prior to the use of statins ( 3, 4 ). Fibrate drugs reduce plasma TG-related VLDLs, raise plasma HDLs ( 5 ), and have a modest effect on LDL cholesterol levels ( 6 ). Fenofi brate acts as a specifi c agonist of PPAR ␣ , a nuclear hormone receptor that functions as a transcription factor and regulates the expression of a number of genes involved in lipid metabolism and insulin resistance. Fenofibrate has been reported to reduce the body weight gain upon high-fat diet (HFD) stimulation ( 7 ). PPAR ␣ lowers serum TG by infl uencing many genes involved in VLDL production, lipid traffi cking, and TG-rich lipoprotein clearance ( 8 ). For example, PPAR ␣ increases the expression of liver microsomal TG transfer protein (MTTP), a protein that mediates the lipidation of apoB100 to form a nascent VLDL ( 9 ); the expression of liver LPL, an enzyme that mediates the clearance of TG-rich VLDL and chylomicrons ( 10 ); and the synthesis of apoC-III ( 11 ), apoA-II ( 12 ), and apoA-V ( 13 ). However, the precise genes underlying the suppressive effect of PPAR ␣ agonists on hepatic VLDL metabolism currently are not well understood.The VLDL receptor (VLDLR), a member of the LDL receptor (LDLR) family, is widely expressed in the heart, skeletal muscles, adipose tissues, and macrophages ( 14, 15 ). However, its levels are barely detectable in the liver under normal conditions. VLDLR mediates the uptake of VLDL by peripheral tissues through LPL-dependent lipolysis or receptor-mediated endocytosis (16)(17)(18)(19), and thus Abstract The liver and the VLDL receptor (VLDLR) play major roles in TG and VLDL metabolism. However, the exact role of liver VLDLR is not well known because of the absence of or diffi culty in detecting VLDLR in the liver. In this study, we demonstrate that fenofi brate, a PPAR␣ agonist and widely used TG-lowering drug, markedly upregulated hepatic VLDLR, which is essential for lowering TG. This study also shows that the distinct regulatory roles of PPAR␣ agonists on VLDLR in the liver and peripheral tissues including adipose tissues, heart, and skeletal muscles are due to the pattern of expression of PPAR␣. The in vivo portion of our study demonstrated that oral fenofi brate robustly increased liver VLDLR expression levels in hyperlipidemic and diabetic mice and signifi cantly reduced the increase in serum TG observed in wt mice after feeding with high-fat diet (HFD) but not in Vldlr ؊ / ؊ mice or Ppar␣ Dyslipidemia is considered one of the major risk factors for the pathogenic progression of many diseases, including CVD...