Cited by 900Liver Disease Diagnosis and TreatmentDiabetes, Cardiovascular Risks, and LipoproteinsDiet, Metabolism, and Disease

Insulin resistance: a metabolic pathway to chronic liver disease

Open access
Bugianesi, Elisabetta, McCullough, Arthur J., Marchesini, Giulio·2005·Hepatology

Abstract

Insulin resistance (IR) is the pathophysiological hallmark of nonalcoholic fatty liver disease (NAFLD), one of the most common causes of chronic liver disease in Western countries. We review the definition of IR, the methods for the quantitative assessment of insulin action, the pathophysiology of IR, and the role of IR in the pathogenesis of chronic liver disease. Increased free fatty acid flux from adipose tissue to nonadipose organs, a result of abnormal fat metabolism, leads to hepatic triglyceride accumulation and contributes to impaired glucose metabolism and insulin sensitivity in muscle and in the liver. Several factors secreted or expressed in the adipocyte contribute to the onset of a proinflammatory state, which may be limited to the liver or more extensively expressed throughout the body. IR is the common characteristic of the metabolic syndrome and its related features. It is a systemic disease affecting the nervous system, muscles, pancreas, kidney, heart, and immune system, in addition to the liver. A complex interaction between genes and the environment favors or enhances IR and the phenotypic expression of NAFLD in individual patients. Advanced fibrotic liver disease is associated with multiple features of the metabolic syndrome, and the risk of progressive liver disease should not be underestimated in individuals with metabolic disorders. Finally, the ability of insulin-sensitizing, pharmacological agents to treat NAFLD by reducing IR in the liver (metformin) and in the periphery (thiazolidinediones) are discussed.

Integrity signals

Registry

Crossref · 10.1002/hep.20920

Cites

161 of 161 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Bugianesi, E., McCullough, A. J., & Marchesini, G.
Affiliations
  • University of Turin (IT)
  • MetroHealth Medical Center (US)
  • University of Bologna (IT)
Corresponding author
Marchesini, Giulio
Venue
Hepatology
Published
2005-11
Volume
42
Issue
5
Pages
987-1000
ISSN
0270-9139 (ISSN-L)
OpenAlex
W2010220662
Cited by
900
References
161
Citations by year
2026: 17 · 2025: 38 · 2024: 34 · 2023: 44 · 2022: 38 · 2021: 53 · 2020: 25 · 2019: 52 · 2018: 43 · 2017: 46 · 2016: 53 · 2015: 57 · 2014: 46 · 2013: 50 · 2012: 33
FWCI
5.17
Type
journal article
Language
en
Open access
Locations
  • Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
  • Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords
insulin resistance, non-alcoholic fatty liver disease, chronic liver disease, metabolic syndrome, hepatic triglyceride accumulation, adipose tissue, insulin sensitivity, inflammation, liver fibrosis, insulin sensitizers, metformin, thiazolidinediones
MeSH terms
Chronic Disease, Fatty Liver, Humans, Insulin Resistance, Liver Diseases

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review