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Brain-gut-liver interactions across the spectrum of insulin resistance in metabolic fatty liver disease

Authors
  • Rebelos, Eleni
  • Iozzo, Patricia
  • Guzzardi, Maria Angela
  • Brunetto, Maurizia Rossana
  • Bonino, Ferruccio
Type
Published Article
Journal
World Journal of Gastroenterology
Publisher
Baishideng Publishing Group Inc
Publication Date
Aug 14, 2021
Volume
27
Issue
30
Pages
4999–5018
Identifiers
DOI: 10.3748/wjg.v27.i30.4999
PMID: 34497431
PMCID: PMC8384743
Source
PubMed Central
Keywords
Disciplines
  • Review
License
Unknown

Abstract

Metabolic associated fatty liver disease (MAFLD), formerly named “nonalcoholic fatty liver disease” occurs in about one-third of the general population of developed countries worldwide and behaves as a major morbidity and mortality risk factor for major causes of death, such as cardiovascular, digestive, metabolic, neoplastic and neuro-degenerative diseases. However, progression of MAFLD and its associated systemic complications occur almost invariably in patients who experience the additional burden of intrahepatic and/or systemic inflammation, which acts as disease accelerator. Our review is focused on the new knowledge about the brain-gut-liver axis in the context of metabolic dysregulations associated with fatty liver, where insulin resistance has been assumed to play an important role. Special emphasis has been given to digital imaging studies and in particular to positron emission tomography, as it represents a unique opportunity for the noninvasive in vivo study of tissue metabolism. An exhaustive revision of targeted animal models is also provided in order to clarify what the available preclinical evidence suggests for the causal interactions between fatty liver, dysregulated endogenous glucose production and insulin resistance.

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