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Metabolic associated fatty liver disease and insulin resistance : a review of complex interlinks
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Barber, Thomas M., Kabisch, Stefan, Pfeiffer, Andreas F. H. and Weickert , Martin (2023) Metabolic associated fatty liver disease and insulin resistance : a review of complex interlinks. Metabolites, 13 (6). 757. doi:10.3390/metabo13060757 ISSN 2218-1989.
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Official URL: https://doi.org/10.3390/metabo13060757
Abstract
Metabolic-associated fatty liver disease (MAFLD) has now surpassed alcohol excess as the most common cause of chronic liver disease globally, affecting one in four people. Given its prevalence, MAFLD is an important cause of cirrhosis, even though only a small proportion of patients with MAFLD ultimately progress to cirrhosis. MAFLD suffers as a clinical entity due to its insidious and often asymptomatic onset, lack of an accurate and reliable non-invasive diagnostic test, and lack of a bespoke therapy that has been designed and approved for use specifically in MAFLD. MAFLD sits at a crossroads between the gut and the periphery. The development of MAFLD (including activation of the inflammatory cascade) is influenced by gut-related factors that include the gut microbiota and intactness of the gut mucosal wall. The gut microbiota may interact directly with the liver parenchyma (through translocation via the portal vein), or indirectly through the release of metabolic metabolites that include secondary bile acids, trimethylamine, and short-chain fatty acids (such as propionate and acetate). In turn, the liver mediates the metabolic status of peripheral tissues (including insulin sensitivity) through a complex interplay of hepatokines, liver-secreted metabolites, and liver-derived micro RNAs. As such, the liver plays a key central role in influencing overall metabolic status. In this concise review, we provide an overview of the complex mechanisms whereby MAFLD influences the development of insulin resistance within the periphery, and gut-related factors impact on the development of MAFLD. We also discuss lifestyle strategies for optimising metabolic liver health.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Fatty liver, Insulin resistance, Fatty liver -- Treatment, Obesity | ||||||
| Journal or Publication Title: | Metabolites | ||||||
| Publisher: | MDPI | ||||||
| ISSN: | 2218-1989 | ||||||
| Official Date: | 15 June 2023 | ||||||
| Dates: |
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| Volume: | 13 | ||||||
| Number: | 6 | ||||||
| Article Number: | 757 | ||||||
| DOI: | 10.3390/metabo13060757 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 20 July 2023 | ||||||
| Date of first compliant Open Access: | 20 July 2023 | ||||||
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