Role of the gut in lipid homeostasis

Physiol Rev. 2012 Jul;92(3):1061-85. doi: 10.1152/physrev.00019.2011.

Abstract

Intestinal lipid transport plays a central role in fat homeostasis. Here we review the pathways regulating intestinal absorption and delivery of dietary and biliary lipid substrates, principally long-chain fatty acid, cholesterol, and other sterols. We discuss the regulation and functions of CD36 in fatty acid absorption, NPC1L1 in cholesterol absorption, as well as other lipid transporters including FATP4 and SRB1. We discuss the pathways of intestinal sterol efflux via ABCG5/G8 and ABCA1 as well as the role of the small intestine in high-density lipoprotein (HDL) biogenesis and reverse cholesterol transport. We review the pathways and genetic regulation of chylomicron assembly, the role of dominant restriction points such as microsomal triglyceride transfer protein and apolipoprotein B, and the role of CD36, l-FABP, and other proteins in formation of the prechylomicron complex. We will summarize current concepts of regulated lipoprotein secretion (including HDL and chylomicron pathways) and include lessons learned from families with genetic mutations in dominant pathways (i.e., abetalipoproteinemia, chylomicron retention disease, and familial hypobetalipoproteinemia). Finally, we will provide an integrative view of intestinal lipid homeostasis through recent findings on the role of lipid flux and fatty acid signaling via diverse receptor pathways in regulating absorption and production of satiety factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Dietary Fats / metabolism*
  • Fatty Acids / metabolism
  • Homeostasis
  • Humans
  • Intestinal Absorption
  • Intestinal Mucosa / metabolism*
  • Lipid Metabolism* / genetics
  • Lipid Metabolism, Inborn Errors / genetics
  • Lipid Metabolism, Inborn Errors / metabolism
  • Lipoproteins / metabolism
  • Membrane Transport Proteins / metabolism
  • Satiety Response
  • Signal Transduction

Substances

  • Dietary Fats
  • Fatty Acids
  • Lipoproteins
  • Membrane Transport Proteins