| Theme |
Nutrition Therapy for Liver Diseases |
| Title |
Glucose Metabolism and the Liver |
| Author |
Takayoshi Sasako |
Department of Metabolic Diseases, The Unirersity of Tokyo |
| Author |
Kojiro Ueki |
Department of Metabolic Diseases, The Unirersity of Tokyo |
| Author |
Takashi Kadowaki |
Department of Metabolic Diseases, The Unirersity of Tokyo |
| [ Summary ] |
The liver plays an important role in glucose homeostasis. It stores glucose during intake, and releases glucose, when fasting. Insulin is a key hormone which modulates glucose metabolism, and lowers blood glucose. It promotes glycogen synthesis and suppresses glycogenolysis as well as gluconeogenesis in the liver. In obese and diabetic patients adipokines which impair insulin action increase, whereas those that improve insulin action decrease. These changes cause insulin resistance in the liver through impaired insulin signaling and glucose metabolism, resulting in hyperinsulinemia through decreased insulin clearance in the liver and elevated insulin secretion from pancreatic beta cells. Hyperinsulinemia not only aggravates hepatic insulin resistance itself, but also induces insulin resistance in other organs, creating a systemic vicious circle. It is also known that liver dysfunction may disrupt glucose metabolism and cause diabetes. |