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25/02/2021

What is hepatic insulin resistance?

What is hepatic insulin resistance?

Hepatic insulin resistance refers to impaired suppression of glucose production by insulin in hepatocytes. Insulin mediates its inhibitory effects on glucose production by inhibiting two key gluconeogenic enzymes, phosphoenolpyruvate carboxykinase (PEPCK) and the glucose-6 phosphatase (G6Pase).

What causes hepatic insulin resistance?

The most noteworthy change found in this study is the development of hepatic insulin resistance and substantial fat accumulation with only a modest increase in dietary fat, suggesting that even a minute increase in fat intake can pose an elevated risk for the development of hepatic insulin resistance.

How is hepatic insulin resistance measured?

Measurement of HGP is by far the most commonly used method of assessing hepatic insulin resistance. HGP itself is measured as part of glucose turnover. Three direct techniques can be used: (1) the arteriovenous-difference technique; (2) the isotope dilution technique; and (3) labelled nuclear MR spectroscopy.

What is muscle insulin resistance?

Abstract. Insulin resistance in skeletal muscle is manifested by decreased insulin-stimulated glucose uptake and results from impaired insulin signaling and multiple post-receptor intracellular defects including impaired glucose transport, glucose phosphorylation, and reduced glucose oxidation and glycogen synthesis.

What is peripheral insulin resistance?

Peripheral insulin resistance: Failure of target tissues to increase glucose disposal in response to insulin.

What is insulin resistance pathogenesis?

Insulin resistance plays a major role in the pathogenesis of type 2 diabetes and the metabolic syndrome. Insulin resistance in skeletal muscle manifests itself primarily as a reduction in insulin-stimulated glycogen synthesis, which is in turn a consequence of reduced glucose transport.

What is the pathophysiology of insulin resistance?

Insulin resistance in skeletal muscle manifests itself primarily as a reduction in insulin-stimulated glycogen synthesis due to reduced glucose transport. Ectopic lipid accumulation plays an important role in inducing insulin resistance.

How does insulin resistance affect glycolysis?

Insulin inhibits gluconeogenesis and glycogenolysis, stimulates glycolysis and glycogenesis, stimulates uptake and incorporation of amino acids into protein, inhibits protein degradation, stimulates lipogenesis, and suppress lipolysis (Bassett, 1975. (1975).

How does insulin resistance occur in the hepatocytes?

Hepatic insulin resistance refers to impaired suppression of glucose production by insulin in hepatocytes. Insulin mediates its inhibitory effects on glucose production by inhibiting two key gluconeogenic enzymes, phosphoenolpyruvate carboxykinase (PEPCK) and the glucose-6 phosphatase (G6Pase).

How is the hepatic insulin resistance index calculated?

In a fasting state, HGP is easily calculated whereas, during insulin or glucose infusion, some formula are needed to correct for the non-steady-state condition. The hepatic insulin-resistance index is the product of HGP and the corresponding plasma insulin concentration.

Which is the best drug for hepatic insulin resistance?

Finally, drugs such as metformin or glitazones can improve hepatic insulin resistance, hence their use in hepatic insulin-resistant states such as type 2 diabetes and non-alcoholic fatty liver disease. Publication types Review MeSH terms

Why is hepatic insulin resistance a hall mark?

Hepatic insulin resistance is a hall mark for the spectrum of many diseases, and it is an independent predictor for metabolic disorders. Recent evidence suggests that visceral adipose tissue is a metabolic and inflammatory organ that signals and modulates the action and metabolism of the brain, liver, muscle, and cardiovascular system [ 24, 25 ].