Gut-derived lipopolysaccharides and metabolic endotoxemia: a critical review.

The metabolic endotoxemia hypothesis proposes that low levels of gut-derived lipopolysaccharides (LPS) act in a hormone-like manner to influence metabolism, contributing to obesity and dysregulation of glucose homeostasis. However, due to methodological limitations, it remains unclear whether a significant amount of bioactive gut-derived LPS reaches the bloodstream and, if so, whether it has a meaningful impact on metabolic processes. In addition, there are several theoretical challenges regarding the coherence of the metabolic endotoxemia hypothesis, raising questions about its validity. Here, in the light of recent literature, we critically review arguments for and against the metabolic endotoxemia hypothesis.