Secondary hyperlipidemia is a major cardiovascular risk factor in individuals with type 2 diabetes. Increased hepatic production of apolipoprotein B (apoB)-containing lipoproteins contributes to the elevated plasma levels, but the mechanism is poorly understood. Recent results have established that microsomal triglyceride transfer protein (MTP) is rate limiting for the assembly and secretion of apoB-containing lipoproteins. To better understand the mechanism of type 2 diabetes-associated hyperlipidemia, we quantified hepatic MTP mRNA levels, hepatic microsomal triglyceride transfer activity, and in vivo triglyceride secretion from the liver in two diabetic mouse models. Obese diabetic (ob/ob) mice had 45% higher (P ؍ 0.006) hepatic MTP mRNA levels, 54% higher (P < 0.0001) microsomal triglyceride transfer activity, and 70% higher (P < 0.0001) in vivo triglyceride secretion rates compared with ob/؉ control mice. In contrast, in lean streptozotocin-treated diabetic mice, hepatic MTP mRNA levels were unchanged, whereas microsomal triglyceride transfer activity and in vivo triglyceride secretion rates were marginally decreased. These studies suggest that obesity-induced type 2 diabetes in mice confers increases in hepatic MTP expression and secretion of triglyceride-rich lipoproteins. High blood glucose and altered hepatic expression of sterol regulatory element binding protein genes play a minor role in this diabetic response. Diabetes 51: 1233-1239, 2002 T he incidence and prevalence of type 2 diabetes are rapidly rising (1). Individuals with type 2 diabetes have an increased risk of cardiovascular disease, which is closely associated with elevation of the plasma levels of apolipoprotein B (apoB)-containing VLDL and LDL (2,3). Metabolic labeling studies have indicated that the increased plasma levels of VLDL and LDL in individuals with diabetes are caused, at least in part, by increased hepatic secretion of apoB-containing lipoproteins (4,5). Hence, a better understanding of the factors in patients with type 2 diabetes that mediate increased lipoprotein secretion from the liver could potentially lead to rational therapeutic strategies to prevent cardiovascular disease in this patient group.During the past 5 years, it has become evident that microsomal triglyceride transfer protein (MTP) is rate limiting for the production of apoB-containing VLDL (6 -10). MTP is an exclusively intracellular protein (6). Its principal role is to transfer lipids onto the apoB polypeptide in the endoplasmic reticulum of lipoprotein-secreting cells (6). Reduction of the MTP activity in animals by MTP inhibitor drugs (7) or genetic manipulations (11,12) lowers plasma lipoprotein levels, whereas adenoviral overexpression of an MTP cDNA in mouse liver in vivo increases hepatic secretion of triglyceride-rich apoB-containing lipoproteins (13,14).Studies of cultured liver cells suggest that insulin and glucose reduce the expression of the MTP gene (15); the MTP gene promoter region contains a putative insulinresponsive element (16). Also, r...