Question 1

What is the Meaning of Hepatic Insulin Resistance?

Accepted Answer

Hepatic insulin resistance describes a state where liver cells, hepatocytes, exhibit diminished responsiveness to insulin. This impairs insulin's normal role in suppressing hepatic glucose production and promoting glucose uptake. Consequently, the liver inappropriately releases glucose into the bloodstream, contributing directly to hyperglycemia.

Question 2

What is the Context of Hepatic Insulin Resistance?

Accepted Answer

This condition is central to glucose homeostasis, a critical component in metabolic regulation. It links to the endocrine system, affecting pancreatic insulin secretion and liver metabolism. Hepatic insulin resistance frequently accompanies prediabetes, type 2 diabetes, and non-alcoholic fatty liver disease, underscoring its role in systemic metabolic dysfunction.

Question 3

What is the Significance of Hepatic Insulin Resistance?

Accepted Answer

Clinically, hepatic insulin resistance is a primary driver of elevated fasting blood glucose, a hallmark of type 2 diabetes. Its presence directly impacts patient management, often necessitating pharmacological interventions and lifestyle adjustments. Understanding this resistance is crucial for interpreting diagnostic markers and guiding therapeutic strategies.

Question 4

What is the Mechanism of Hepatic Insulin Resistance?

Accepted Answer

At a cellular level, hepatic insulin resistance stems from impaired intracellular insulin signaling within hepatocytes. Insulin typically binds to its receptor, initiating phosphorylation events. When resistance occurs, these pathways are disrupted, leading to reduced inhibition of gluconeogenesis and glycogenolysis. This results in uncontrolled hepatic glucose output, despite circulating insulin.

Question 5

What is the Application of Hepatic Insulin Resistance?

Accepted Answer

Hepatic insulin resistance manifests as persistently elevated blood glucose, particularly fasting. Addressing this resistance is a primary objective in managing type 2 diabetes and metabolic syndrome. Therapeutic approaches often involve agents enhancing liver insulin sensitivity, combined with dietary modifications and regular physical activity to improve metabolic responsiveness.

Question 6

What is the Metric of Hepatic Insulin Resistance?

Accepted Answer

The presence and degree of hepatic insulin resistance are primarily assessed indirectly through biochemical markers. Common measurements include fasting plasma glucose and fasting insulin levels, used to calculate indices such as HOMA-IR. Elevated liver enzymes or imaging findings indicating hepatic steatosis may also suggest liver involvement.

Question 7

What is the Risk of Hepatic Insulin Resistance?

Accepted Answer

Unmanaged hepatic insulin resistance poses significant health risks, increasing the likelihood of progressing to overt type 2 diabetes. This persistent metabolic dysregulation contributes to dyslipidemia, elevated cardiovascular disease risk, and the advancement of non-alcoholic fatty liver disease. Without intervention, sustained demand on pancreatic beta-cells can lead to their exhaustion and failure.

Hepatic Insulin Resistance

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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