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NAFLD and Insulin Resistance: A Multisystemic Disease

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Non-Alcoholic Fatty Liver Disease

Abstract

NAFLD is an emerging metabolic disease that is affecting almost 25% of the world population. NAFLD is more prevalent in obese subjects or in patients with type 2 diabetes (T2D) where the prevalence is much higher. The pathophysiology of NAFLD is still not completely understood. However, alteration in both glucose and lipid metabolism, mainly because of impairment in insulin action (i.e., insulin resistance) and insulin secretion, is among the major causes of hepatic fat accumulation (steatosis) and its progression to more severe liver disease including nonalcoholic steatohepatitis (NASH). In this chapter, I reviewed the current knowledge on insulin resistance in NAFLD and its impact on the metabolic cross talk among liver, muscle, and adipose tissue.

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Abbreviations

AA:

Amino acids

AKT:

Protein kinase B

BCAA:

Branched chain amino acids

DAG:

Diacylglycerols

DNL:

De novo lipogenesis

EGP:

Endogenous glucose production

FFA:

Free fatty acids

FOXO1:

Forkhead box protein O1

GNG:

Gluconeogenesis

Hep-IR:

Hepatic insulin resistance

IHTG:

Intrahepatic TG

IR:

Insulin resistance

IRS-1 and IRS-2:

Insulin receptor substrates

OGTT:

Oral glucose tolerance test

PEPCK:

Phosphoenol-pyruvate carboxykinase

Ra:

Rate of appearance

T2D:

Type 2 diabetes

TG:

Triglyceride

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    A. Gastaldelli

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    Elisabetta Bugianesi

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Gastaldelli, A. (2020). NAFLD and Insulin Resistance: A Multisystemic Disease. In: Bugianesi, E. (eds) Non-Alcoholic Fatty Liver Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-95828-6_4

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