Abstract
Over 65 % of people with obesity display the metabolic-associated fatty liver disease (MAFLD), which can manifest as steatohepatitis, fibrosis, cirrhosis, or liver cancer. The development and progression of MAFLD involve hepatic insulin resistance and reduced insulin clearance. This review discusses the relationships between altered insulin signaling, hepatic insulin resistance, and reduced insulin clearance in the development of MAFLD and how this provides the impetus for exploring the use of insulin sensitizers to curb this disease. The review also explores the role of the insulin receptor in hepatocytes and hepatic stellate cells and how it signals in metabolic and end-stage liver diseases. Finally, we discuss new research findings that indicate that advanced hepatic diseases may be an insulin-sensitive state in the liver and deliberate whether insulin sensitizers should be used to manage late-stage liver diseases.
Original language | English |
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Article number | 155607 |
Journal | Metabolism: Clinical and Experimental |
Volume | 145 |
DOIs | |
State | Published - Aug 2023 |
Bibliographical note
Publisher Copyright:© 2023
Keywords
- Cirrhosis
- Fatty liver
- Hepatic stellate cells
- Hepatocytes
- Insulin clearance
- Insulin resistance
- Lipogenesis
- MAFLD
- MASH
- NAFLD
- NASH
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Endocrinology