Obesity is an increasingly prevalent health problem, very often accompanied by other diseases, the most common being insulin resistance, type 2 diabetes mellitus, and cardiovascular complications ( 1, 2 ). Furthermore, an association has been reported between obesity and both oxidative stress and increased infl ammation ( 3, 4 ). Obesity facilitates the development of a low-grade infl ammatory state, characterized by increased plasma levels of proinfl ammatory cytokines ( 4 ). However, the factors that trigger this low-grade infl ammation in obesity are unclear. Postprandial lipidemia has recently emerged as a potential candidate because the ingestion of a highfat meal leads to the systemic increase of a wide range of infl ammatory mediators ( 5-7 ) and an increase in oxidative stress markers ( 8 ). However, the cause of these postprandial events that occur in association with the postprandial triglyceride response remains poorly understood. A possible link is bacterial endotoxin [lipopolysaccharide (LPS)], a component of the Gram-negative bacteria cell wall that is present in large quantities in the human gut ( 9 ). Endotoxins circulate in the plasma Abstract The low-grade infl ammation observed in obesity has been associated with a high-fat diet, though this relation is not fully understood. Bacterial endotoxin, produced by gut microbiota, may be the linking factor. However, this has not been confi rmed in obese patients. To study the relationship between a high-fat diet and bacterial endotoxin, we analyzed postprandial endotoxemia in morbidly obese patients after a fat overload. The endotoxin levels were determined in serum and the chylomicron fraction at baseline and 3 h after a fat overload in 40 morbidly obese patients and their levels related with the degree of insulin resistance and postprandial hypertriglyceridemia. The morbidly obese patients with the highest postprandial hypertriglyceridemia showed a signifi cant increase in lipopolysaccharide (LPS) levels in serum and the chylomicron fraction after the fat overload. Postprandial chylomicron LPS levels correlated positively with the di ff erence between postprandial triglycerides and baseline triglycerides. There were no signifi cant correlations between C-reactive protein (CRP) and LPS levels. The main variables contributing to serum LPS levels after fat overload were baseline and postprandial triglyceride levels but not glucose or insulin resistance. Additionally, superoxide dismutase activity decreased signifi cantly after the fat overload. Postprandial LPS increase after a fat overload is related to postprandial hypertriglyceridemia but not to degree of insulin resistance in morbidly obese patients. -Clemente-Postigo, M., M. I. Queipo-Ortuño,