胰岛素抵抗和长期的肝疾病

• 作者: Eitaro Taniguchi Masahiro Sakata Michio Sata Minoru Itou Shuji Sumie Takumi Kawaguchi
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: VIRAL HEPATITIS HYPERINSULINEMIA HYPOGLYCEMIC DRUG HEPATOMA
• 年，卷（期）: 2011,（5）
• 页码范围: 99-107
• 页数: 9页
• 分类号: R575

摘要

Increased insulin resistance is frequently associated with chronic liver disease and is a pathophysiological feature of hepatogenous diabetes.Distinctive factors including hepatic parenchymal cell damage,portalsystemic shunting and hepatitis C virus are responsible for the development of hepatogenous insulin resistance/diabetes.Although it remains unclear whether insulin secretion from pancreatic beta cells is impaired as it is in type 2 diabetes,retinopathic and cardiovascular risk is low and major causes of death in cirrhotic patients with diabetes are liver failure,hepatocellular carcinoma and gastrointestinal hemorrhage.Hemoglobin A1c is an inaccurate marker for the assessment and management of hepatogenous diabetes.Moreover,exogenous insulin or sulfonylureas may be harmful because these agents may promote hepatocarcinogenesis.Thus,pathogenesis,cause of death,assessment and therapeutic strategy for hepatogenous insulin resistance/diabetes differ from those for lifestyle-related type 2 diabetes.In this article,we review features of insulin resistance in relationship to chronic liver disease.We also discuss the impact of anti-diabetic agents on interferon treatment and hepatocarcinogenesis.