Insulin Resistance: A Metabolic Pathway to Chronic Liver Disease

onlinelibrary.wiley.com/doi...

Insulin resistance (IR) is the pathophysiological hallmark of nonalcoholic fatty liver disease (NAFLD), one of the most common causes of chronic liver disease in Western countries. We review the definition of IR, the methods for the quantitative assessment of insulin action, the pathophysiology of IR, and the role of IR in the pathogenesis of chronic liver disease.

Increased free fatty acid flux from adipose tissue to nonadipose organs, a result of abnormal fat metabolism, leads to hepatic triglyceride accumulation and contributes to impaired glucose metabolism and insulin sensitivity in muscle and in the liver. Several factors secreted or expressed in the adipocyte contribute to the onset of a proinflammatory state, which may be limited to the liver or more extensively expressed throughout the body. IR is the common characteristic of the metabolic syndrome and its related features. It is a systemic disease affecting the nervous system, muscles, pancreas, kidney, heart, and immune system, in addition to the liver. A complex interaction between genes and the environment favors or enhances IR and the phenotypic expression of NAFLD in individual patients. Advanced fibrotic liver disease is associated with multiple features of the metabolic syndrome, and the risk of progressive liver disease should not be underestimated in individuals with metabolic disorders. Finally, the ability of insulin-sensitizing, pharmacological agents to treat NAFLD by reducing IR in the liver (metformin) and in the periphery (thiazolidinediones) are discussed.

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  • cure @anup Shashikantiyengar shrisamarth

    Increased free fatty acid flux from adipose tissue to nonadipose organs, a result of abnormal fat metabolism, leads to hepatic triglyceride accumulation and contributes to impaired glucose metabolism and insulin sensitivity in muscle and in the liver

    So, my question to you all is "Fatty acids due to abnormal fat metabolism are responsible for triglyceride accumulation and ultimately reduce insulin sensitivity or high carb intake causes increase in triglyceride levels in blood as you all said in one of my post before?

  • Sorry Ashka, your question is a little confusing.

  • Pl check

    eatingacademy.com/weight-lo...

    The "General" of the army of all hormones regulating the process is Insulin, as Dr Attia says. So, lower the insulin level in blood. How? Cut down carbs

    It's the High Carbs. All the cascading effect starts from there.

    Attia's positive fat flux probably is what is being referred to as "abnormal fat metabolism" here.

    Cutting down carbs cuts down TG.

  • High Carb + High fats.. Above problem will happen

    Low carb + High Fats .. Above problem will not occur

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