Kawaguchi T, Taniguchi E, Itou M, Sakata M, Sumie S, Sata M. Insulin resistance and chronic liver disease. World J Hepatol 2011; 3(5): 99-107 [PMID: 21731901 DOI: 10.4254/wjh.v3.i5.99]
Corresponding Author of This Article
Takumi Kawaguchi, MD, PhD, Department of Digestive Disease Information & Research, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. takumi@med.kurume-u.ac.jp
Article-Type of This Article
Editorial
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Takumi Kawaguchi, Michio Sata, Department of Disease Information & Research, Kurume University School of Medicine, Kurume 830-0011, Japan
Takumi Kawaguchi, Eitaro Taniguchi, Minoru Itou, Masahiro Sakata, Shuji Sumie, Michio Sata, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
Author contributions: Kawaguchi T, Taniguch E, Itou M, Sakata M and Sumie S drafted the manuscript; Kawaguchi T and Sata M organized and revised the manuscript.
Supported by the Grant-in-Aid for Young Scientists (B)(No. 22790874 to T.K.) and a Grant-in-Aid for Scientific Research (C)(No. 21590865 to M.S.) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, and by Health and Labour Sciences Research Grants for Research on Hepatitis from the Ministry of Health, Labour and Welfare of Japan
Correspondence to: Takumi Kawaguchi, MD, PhD, Department of Digestive Disease Information & Research, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. takumi@med.kurume-u.ac.jp
Telephone: +81-942-31-7902 Fax: +81-942-31-7820
Received: November 18, 2010 Revised: March 26, 2011 Accepted: April 2, 2011 Published online: May 27, 2011
Abstract
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, portal-systemic 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.
