Cited by 252Adipokines, Inflammation, and Metabolic DiseasesLiver Disease Diagnosis and TreatmentLiver physiology and pathology

The DOI matches its Crossref record; 276 of the 278 references it cites were found in a registry or an index; 11 of the 225 sources its claims cite were checked for support.

Hepatokines and metabolism: Deciphering communication from the liver

Open access
Jensen-Cody, Sharon O., Potthoff, Matthew J.·2021·Molecular Metabolism

Abstract

BACKGROUND: The liver is a key regulator of systemic energy homeostasis and can sense and respond to nutrient excess and deficiency through crosstalk with multiple tissues. Regulation of systemic energy homeostasis by the liver is mediated in part through regulation of glucose and lipid metabolism. Dysregulation of either process may result in metabolic dysfunction and contribute to the development of insulin resistance or fatty liver disease. SCOPE OF REVIEW: The liver has recently been recognized as an endocrine organ that secretes hepatokines, which are liver-derived factors that can signal to and communicate with distant tissues. Dysregulation of liver-centered inter-organ pathways may contribute to improper regulation of energy homeostasis and ultimately metabolic dysfunction. Deciphering the mechanisms that regulate hepatokine expression and communication with distant tissues is essential for understanding inter-organ communication and for the development of therapeutic strategies to treat metabolic dysfunction. MAJOR CONCLUSIONS: In this review, we discuss liver-centric regulation of energy homeostasis through hepatokine secretion. We highlight key hepatokines and their roles in metabolic control, examine the molecular mechanisms of each hepatokine, and discuss their potential as therapeutic targets for metabolic disease. We also discuss important areas of future studies that may contribute to understanding hepatokine signaling under healthy and pathophysiological conditions.

Overview

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Written from the paper’s full text.

TL;DR

This review describes the liver as an endocrine organ that secretes hepatokines to regulate systemic energy, glucose, and lipid homeostasis. It summarizes key hepatokines, their target tissues and metabolic roles, and discusses their therapeutic potential and unresolved questions in metabolic disease.

Key findings

  • The review classifies hepatokines by metabolic impact: beneficial hepatokines include activin-E, ANGPTL4, ANGPTL6, FGF21, GDF15, IGF-1, LCN13, SMOC1, and TSK; detrimental hepatokines include ANGPTL3, ANGPTL8, fetuin-A, hepassocin, LECT-2, and selenoprotein-P.
  • Table 1 reports human serum concentration changes in insulin resistance: increased for activin-E, ANGPTL3, ANGPTL6, fetuin-A, FGF21, follistatin, GDF15, hepassocin, LECT2, selenoprotein-P, and Tsukushi; decreased for IGF1, LCN13, and SMOC1; debated for ANGPTL4 and ANGPTL8.
  • Several mechanisms are highlighted, including FGF21 signaling through FGFR1c/β-klotho, GDF15 signaling through GFRAL/RET, and ANGPTL3/ANGPTL8 complex inhibition of lipoprotein lipase.
  • The review notes that elevated levels of some hepatokines in obesity and diabetes may reflect endocrine resistance, similar to insulin or leptin resistance, and that hepatokines are promising but incompletely validated therapeutic targets.

Methods

  • Narrative review; no primary experiments, systematic search strategy, or meta-analysis are described.
  • The paper synthesizes published rodent and human literature, including genetic, pharmacological, and clinical trial findings, and presents a summary table of hepatokines with target organs, metabolic roles, and human serum concentration changes in insulin resistance.
  • Main analysis is qualitative: mechanisms, target tissues, physiological contexts, and therapeutic implications are discussed for each selected hepatokine.

Limitations

  • Stated: the review is “not meant to be an exhaustive list”; future studies are needed to determine how hepatokines integrate with other organokines, how preclinical evidence translates to humans, how hepatokines contribute to disease progression, and how each hepatokine is regulated and acts under healthy and pathophysiological conditions.
  • Stated/evident: conflicting findings exist for some hepatokines, such as debated circulating ANGPTL4 and ANGPTL8 levels in metabolic disease and non-reproduced TSK knockout results in a subsequent study.
  • Evident: as a narrative review, it lacks systematic search, quantitative synthesis, and primary data to establish causality or effect sizes.

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Integrity signals

Registry

Crossref · 10.1016/j.molmet.2020.101138

Cites

276 of 276 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Figure 1 Hepatic production of secreted factors controls nutrient and energy homeostasis. The liver plays a central role in regulating systemic energy balance by sensing nutrient availability and altering metabolite and energy production used by various organ systems. The liver communicates with these tissues in part through the production of hepatokines, which are responsible for transmitting information regarding the metabolic status of the liver to target organs, including the CNS, adipose tissues, and muscle. This information is communicated back to the liver in a feedforward loop through hepatokines and other secreted factors, including those produced by the pancreas, to maintain energy balance in response to constant changes in nutrient status. CNS, central nervous system; GDF15, growth differentiation factor 15; FGF21, fibroblast growth factor 21; TSK, Tsukushi; FST, follistatin; ANGPTL, angiopoietin-like; LCN13, lipocalin 13; SMOC1, SPARC-related modular calcium-binding protein-1; IGF1, insulin-like growth factor 1; LECT2, leukocyte cell-derived chemotaxin 2.
Figure 1 Hepatic production of secreted factors controls nutrient and energy homeostasis. The liver plays a central role in regulating systemic energy balance by sensing nutrient availability and altering metabolite and energy production used by various organ systems. The liver communicates with these tissues in part through the production of hepatokines, which are responsible for transmitting information regarding the metabolic status of the liver to target organs, including the CNS, adipose tissues, and muscle. This information is communicated back to the liver in a feedforward loop through hepatokines and other secreted factors, including those produced by the pancreas, to maintain energy balance in response to constant changes in nutrient status. CNS, central nervous system; GDF15, growth differentiation factor 15; FGF21, fibroblast growth factor 21; TSK, Tsukushi; FST, follistatin; ANGPTL, angiopoietin-like; LCN13, lipocalin 13; SMOC1, SPARC-related modular calcium-binding protein-1; IGF1, insulin-like growth factor 1; LECT2, leukocyte cell-derived chemotaxin 2.CC BY-NC-ND · PubMed Central
Figure 2 Mechanism for physiological effects of hepatokines in target tissues. Hepatokines elicit diverse effects on target tissues. Some hepatokines signal the CNS to regulate body weight homeostasis and nutrient intake, while others act on adipose tissues and muscle to regulate lipid and glucose homeostasis. GDF15, growth differentiation factor 15; FGF21, fibroblast growth factor 21; FST, follistatin; LCN13, lipocalin 13; TSK, Tsukushi; IGF1, insulin-like growth factor 1; UCP1, uncoupling protein 1; SMOC1, SPARC-related modular calcium-binding protein-1; ANGPTL6, angiopoietin-like 6; AMPK, 5′ adenosine monophosphate-activated protein kinase.
Figure 2 Mechanism for physiological effects of hepatokines in target tissues. Hepatokines elicit diverse effects on target tissues. Some hepatokines signal the CNS to regulate body weight homeostasis and nutrient intake, while others act on adipose tissues and muscle to regulate lipid and glucose homeostasis. GDF15, growth differentiation factor 15; FGF21, fibroblast growth factor 21; FST, follistatin; LCN13, lipocalin 13; TSK, Tsukushi; IGF1, insulin-like growth factor 1; UCP1, uncoupling protein 1; SMOC1, SPARC-related modular calcium-binding protein-1; ANGPTL6, angiopoietin-like 6; AMPK, 5′ adenosine monophosphate-activated protein kinase.CC BY-NC-ND · PubMed Central
Figure 3 Regulation of hepatokine function during obesity and diabetes. Signaling of certain hepatokines to target tissues including skeletal muscle and adipose tissues may result in impaired lipid and glucose homeostasis, ultimately leading to metabolic dysregulation. Some hepatokines increase in the circulation under inflammation conditions, which may result in endocrine-signaling resistance. ANGPTL3, 8, 4, angiopoietin-like 3, 8, 4; LPL, lipoprotein lipase; FFA, free fatty acid; FST, follistatin; LECT2, leukocyte cell-derived chemotaxin 2; HFREP1, hepassocin; IL1β, interleukin-1 beta; TNF-α, tumor necrosis factor alpha; IL6, interleukin-6; AMPK, 5′ adenosine monophosphate-activated protein kinase; FGF21, fibroblast growth factor 21; SMOC1, SPARC-related modular calcium-binding protein-1; ANGPTL6, angiopoietin-like 6.
Figure 3 Regulation of hepatokine function during obesity and diabetes. Signaling of certain hepatokines to target tissues including skeletal muscle and adipose tissues may result in impaired lipid and glucose homeostasis, ultimately leading to metabolic dysregulation. Some hepatokines increase in the circulation under inflammation conditions, which may result in endocrine-signaling resistance. ANGPTL3, 8, 4, angiopoietin-like 3, 8, 4; LPL, lipoprotein lipase; FFA, free fatty acid; FST, follistatin; LECT2, leukocyte cell-derived chemotaxin 2; HFREP1, hepassocin; IL1β, interleukin-1 beta; TNF-α, tumor necrosis factor alpha; IL6, interleukin-6; AMPK, 5′ adenosine monophosphate-activated protein kinase; FGF21, fibroblast growth factor 21; SMOC1, SPARC-related modular calcium-binding protein-1; ANGPTL6, angiopoietin-like 6.CC BY-NC-ND · PubMed Central

Verification

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Citations

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  1. Patrick Auberger, 1989, Jean olivier contreres, gilles pages, ginette le cam, bernard rossi, alphonse le cam, vol. 58

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Metadata

Authors
Jensen-Cody, S. O., & Potthoff, M. J.
Affiliations
University of Iowa (US)
Corresponding author
Potthoff, Matthew J.
Venue
Molecular Metabolism
Publisher
Elsevier BV
Published
2021-02
Volume
44
Pages
101138
ISSN
2212-8778 (ISSN-L)
OpenAlex
W3112435365
Cited by
252
References
278
Citations by year
2026: 42 · 2025: 54 · 2024: 58 · 2023: 41 · 2022: 36 · 2021: 21
FWCI
3.58
Type
journal article
Language
en
Open access
Locations
  • Molecular Metabolism (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institutes of Health
  • U.S. Department of Veterans Affairs
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Liver physiology and pathology
Keywords
hepatokines, energy homeostasis, inter-organ communication, glucose metabolism, lipid metabolism, insulin resistance, hepatic steatosis, metabolic dysfunction, therapeutic target
MeSH terms
Nutrients, Animals, Diabetes Mellitus, Type 2, Fatty Liver, Glucose, Homeostasis, Humans, Insulin Resistance, Liver, Metabolic Diseases, Obesity, Cytokines, Lipid Metabolism

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