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Unraveling the Regulation of Hepatic Metabolism by Insulin #MMPMID28416361
Titchenell PM; Lazar MA; Birnbaum MJ
Trends Endocrinol Metab 2017[Jul]; 28 (7): 497-505 PMID28416361show ga
During insulin-resistant states such as type 2 diabetes mellitus (T2DM), insulin fails to suppress hepatic glucose production yet promotes lipid synthesis leading to hyperglycemia and hypertriglyceridemia. Defining the downstream signaling pathways underlying the control of hepatic metabolism by insulin is necessary for understanding both normal physiology and the pathogenesis of metabolic disease. Here, we summarize recent literature highlighting the importance of both hepatic and extra-hepatic mechanisms in insulin?s regulation of liver glucose and lipid metabolism. We posit that a failure of insulin to inappropriately regulate liver metabolism during T2DM is not exclusively from an inherent defect in canonical liver insulin signaling but, rather, due to a combination of hyperinsulinemia, altered substrate supply, and the input of several extra-hepatic signals.