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The liver in obesity and type 2 diabetes mellitus.

Publication ,  Journal Article
Li, Z; Clark, J; Diehl, AM
Published in: Clin Liver Dis
November 2002

Obesity and type 2 diabetes are associated strongly with NAFLD. It is not clear if one of these conditions causes the others, or if all are consequences of another process. Although NAFLD is known to occur in overly lean individuals, which indicates that excessive adiposity is not required for the development of NAFLD, the severities of insulin resistance and NAFLD tend to parallel each other, and the greatest prevalence of type 2 diabetes occurs in patients with NAFLD and cirrhosis. This observation suggests that insulin resistance and NAFLD may be related pathogenically. Experiments in mice demonstrate that insulin resistance and NAFLD result from a chronic inflammatory state that is characterized by increased levels of TNF alpha. The mechanisms that drive this chronic inflammation are unknown but might involve the oxidative stress that develops during fatty acid metabolism or when products from intestinal bacteria escape into the mesenteric blood to trigger a sustained hepatic inflammatory cytokine response in genetically susceptible individuals, promoting a positive feedback loop that reinforces insulin resistance and inflammation. This hypothesis is supported by some animal and human studies; however, more research is needed to evaluate this theory. Additional studies also are required to determine the benefits of treatments that interrupt this pathogenic cascade at various points. Preliminary work in animal and human studies suggests that diverse strategies that inhibit production of TNF alpha and improve insulin resistance also ameliorate NAFLD.

Duke Scholars

Published In

Clin Liver Dis

DOI

ISSN

1089-3261

Publication Date

November 2002

Volume

6

Issue

4

Start / End Page

867 / 877

Location

United States

Related Subject Headings

  • Obesity
  • Humans
  • Gastroenterology & Hepatology
  • Fatty Liver
  • Diabetes Mellitus, Type 2
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
MLA
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Li, Z., Clark, J., & Diehl, A. M. (2002). The liver in obesity and type 2 diabetes mellitus. Clin Liver Dis, 6(4), 867–877. https://doi.org/10.1016/s1089-3261(02)00060-0
Li, Zhiping, Jeanne Clark, and Anna Mae Diehl. “The liver in obesity and type 2 diabetes mellitus.Clin Liver Dis 6, no. 4 (November 2002): 867–77. https://doi.org/10.1016/s1089-3261(02)00060-0.
Li Z, Clark J, Diehl AM. The liver in obesity and type 2 diabetes mellitus. Clin Liver Dis. 2002 Nov;6(4):867–77.
Li, Zhiping, et al. “The liver in obesity and type 2 diabetes mellitus.Clin Liver Dis, vol. 6, no. 4, Nov. 2002, pp. 867–77. Pubmed, doi:10.1016/s1089-3261(02)00060-0.
Li Z, Clark J, Diehl AM. The liver in obesity and type 2 diabetes mellitus. Clin Liver Dis. 2002 Nov;6(4):867–877.
Journal cover image

Published In

Clin Liver Dis

DOI

ISSN

1089-3261

Publication Date

November 2002

Volume

6

Issue

4

Start / End Page

867 / 877

Location

United States

Related Subject Headings

  • Obesity
  • Humans
  • Gastroenterology & Hepatology
  • Fatty Liver
  • Diabetes Mellitus, Type 2
  • 3202 Clinical sciences
  • 1103 Clinical Sciences