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Commentary on the study of Laatsch et al. “Insulin stimulates hepatic low density lipoprotein receptor-related protein 1 (LRP1) to increase postprandial lipoprotein clearance”

      Insulin resistance and type 2 diabetes are associated with an increased cardiovascular disease risk [
      • Razani B.
      • Chakravarthy M.V.
      • Semenkovich C.F.
      Insulin resistance and atherosclerosis.
      ]. Among many different mechanisms associated with the atherosclerotic process like inflammation, a pro-coagulant state and the presence of atherogenic dyslipdemia measured in the fasting state, prolonged postprandial lipemia responses have been shown in these subjects [
      • Annuzzi G.
      • De Natale C.
      • Iovine C.
      • et al.
      Insulin resistance is independently associated with postprandial alterations of triglyceride-rich lipoproteins in type 2 diabetes mellitus.
      ,
      • Hsieh J.
      • Hayashi A.A.
      • Webb J.
      • Adeli K.
      Postprandial dyslipidemia in insulin resistance: mechanisms and role of intestinal insulin sensititvity.
      ]. There is strong evidence of the association between disturbances in chylomicron and remnant removal from plasma and atherosclerosis [
      • Groot P.H.
      • van Stiphout W.A.
      • Kraus X.H.
      • et al.
      Postprandial lipoprotein metabolism in normolipidemic men with and without coronary artery disease.
      ,
      • Kugiyama K.
      • Doi H.
      • Takazoe K.
      • et al.
      Remnant lipoprotein levels in fasting serum predict coronary events in patients with coronary artery disease.
      ,
      • Sposito A.C.
      • Lemos P.A.
      • Santos R.D.
      • et al.
      Impaired intravascular triglyceride lipolysis constitutes a marker of clinical outcome in patients with stable angina undergoing secondary prevention treatment: a long-term follow-up study.
      ,
      • Nordestgaard B.G.
      • Benn M.
      • Schnohr P.
      • Tybjaerg-Hansen A.
      Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women.
      ]. Chylomicrons and their remnants can be atherogenic either directly by inducing endothelial dysfunction, by the deposit of cholesterol-rich remnants in the arterial wall, or indirectly by hampering the catabolism of very low density lipoproteins (VLDLs) and its remnants and by disturbing the reverse cholesterol transport mechanism [
      • Mamo J.C.L.
      • Proctor S.D.
      • Smith D.
      Retention of chylomicron remnants by arterial tissue: importance of an efficient clearance mechanism from plasma.
      ,
      • Cohn J.S.
      Postprandial lipemia and remnant lipoproteins.
      ].
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