Hypothalamic control of hepatic lipid metabolism via the autonomic nervous system.

Our body is well designed to store energy in times of nutrient excess, and release energy in times of food deprivation. This adaptation to the external environment is achieved by humoral factors and the autonomic nervous system. Claude Bernard, in the 19th century, showed the importance of the autonomic nervous system in the control of glucose metabolism. In the 20th century, the discovery of insulin and the development of techniques to measure hormone concentrations shifted the focus from the neural control of metabolism to the secretion of hormones, thus functionally "decapitating" the body. Just before the end of the 20th century, starting with the discovery of leptin in 1994, the control of energy metabolism went back to our heads. Since the start of 21st century, numerous studies have reported the involvement of hypothalamic pathways in the control of hepatic insulin sensitivity and glucose production. The autonomic nervous system is, therefore, acknowledged to be one of the important determinants of liver metabolism and a possible treatment target. In this chapter, we review research to date on the hypothalamic control of hepatic lipid metabolism.