ALPI and metabolic syndrome: The anti-inflammatory gut brush border enzyme intestinal alkaline phosphatase (IAP) is an essential regulator of intestinal homeostasis; it detoxifies LPS, stabilizes the natural intestinal flora, and regulates the barrier function of the intestine.73–79 In addition, IAP has been shown to play an essential regulatory role in glucose and lipid metabolism and counteract metabolic syndrome development.80,81 Reduced IAP activity has been measured in chronic diseases such as diabetes mellitus, liver cirrhosis, cardiovascular disease, and older age.