Cardiometabolic Risk Unit, Institute of Clinical Physiology, CNR, Pisa, Italy; Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy.
Cardiometabolic Risk Unit, Institute of Clinical Physiology, CNR, Pisa, Italy; Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy.
Curr Opin Pharmacol. 2020 Dec;55:165-174. doi: 10.1016/j.coph.2020.10.016. Epub 2020 Dec 2.
In this review we have discussed how the liver plays a central role in the regulation of glucose metabolism and in insulin clearance. Both non-alcoholic fatty liver disease (NAFLD) and diabetes (T2D) are characterized by high plasma insulin concentrations, hepatic insulin resistance, high hepatic glucose production (HGP), in particular gluconeogenesis (GNG), that are increased proportionally to fasting hyperglycemia, while postprandial hyperglycemia is due to impaired suppression of HGP by insulin, and reduced hepatic glycogen storage. The liver acts also as a modulator of peripheral insulin since most of insulin secreted by the pancreas is cleared by the liver during the first pass. Hepatokines and hepatic lipids can act in either autocrine or paracrine way and can be responsible of the changes in insulin sensitivity and alterations in glucose metabolism.
在这篇综述中，我们讨论了肝脏在调节葡萄糖代谢和胰岛素清除中的核心作用。非酒精性脂肪性肝病（NAFLD）和糖尿病（T2D）的特征均为高血浆胰岛素浓度、肝胰岛素抵抗、高肝葡萄糖生成（HGP），特别是糖异生（GNG），这些与空腹高血糖成正比，而餐后高血糖则是由于胰岛素对 HGP 的抑制作用受损以及肝糖原储存减少所致。肝脏也是外周胰岛素的调节剂，因为胰腺分泌的大部分胰岛素在首过效应中被肝脏清除。肝因子和肝脂类可以通过自分泌或旁分泌的方式发挥作用，并且可能是胰岛素敏感性变化和葡萄糖代谢改变的原因。
