The metabolic actions of glucagon revisited
Open accessAbstract
The initial identification of glucagon as a counter-regulatory hormone to insulin revealed this hormone to be of largely singular physiological and pharmacological purpose. Glucagon agonism, however, has also been shown to exert effects on lipid metabolism, energy balance, body adipose tissue mass and food intake. The ability of glucagon to stimulate energy expenditure, along with its hypolipidemic and satiating effects, in particular, make this hormone an attractive pharmaceutical agent for the treatment of dyslipidemia and obesity. Studies that describe novel preclinical applications of glucagon, alone and in concert with glucagon-like peptide 1 agonism, have revealed potential benefits of glucagon agonism in the treatment of the metabolic syndrome. Collectively, these observations challenge us to thoroughly investigate the physiology and therapeutic potential of insulin's long-known opponent.
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Beyond weight loss, retatrutide's lipid effects may be partly driven by its triple agonism, particularly glucagon receptor activation, which enhances lipid oxidation and reduces hepatic lipid synthesis.
“Beyond WL, these effects may be partly driven by its triple agonism, particularly glucagon receptor activation, which enhances lipid oxidation and reduces hepatic lipid synthesis [56].”
From Triple Agonism Based Therapies for Obesity (2025) · cites this paper as [56]
The “Glucagon and lipid metabolism” section reports that glucagon stimulated fatty-acid oxidation and inhibited lipogenesis in rabbit hepatocytes; it also reports increased oxidation in primary human hepatocytes. This supports the proposed glucagon mechanism, but the paper discusses glucagon–GLP-1 dual agonism, not retatrutide or triple agonism, so it does not establish that this mechanism drives retatrutide’s lipid effects. (LLM, conf=0.88)
Experimental — accuracy not yet measuredGlucagon acts not only to increase glucose production but also to induce lipolysis, fatty acid oxidation, ketogenesis, increase thermogenesis and energy expenditure, bile acid synthesis, and induce satiation and reduce food intake.
“Therefore, glucagon acts not only to increase glucose production but also to induce lipolysis, fatty acid oxidation, ketogenesis, increase thermogenesis and energy expenditure, bile acid synthesis, and finally induce satiation and reduce food intake [22, 23].”
From Dual and Triple Incretin-Based Co-agonists: Novel Therapeutics for Obesity and Diabetes (2024) · cites this paper as [22]
The sections on lipid metabolism, energy expenditure, and food intake support the claimed effects on lipolysis, fatty acid oxidation, ketogenesis, thermogenesis, energy expenditure, and satiation. The bile acid metabolism section does not establish that glucagon induces bile acid synthesis: it reports reduced expression of a rate-limiting enzyme and says the direct effect on synthesis remains unknown, although the lipid metabolism section reports elevated conversion of cholesterol to bile acids in rats. Page numbers were not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredFurther glucagon actions include improvement of whole body lipid metabolism and promotion of hepatic fatty acid oxidation, which may provide therapeutic actions for MASLD and/or MASH.
“Further glucagon actions include the improvement of the whole body lipid metabolism and the promotion of hepatic fatty acid oxidation which may provide therapeutic actions for MASLD and/or MASH [60].”
From What is the pipeline for future medications for obesity? (2025) · cites this paper as [60]
In ‘Glucagon and lipid metabolism,’ the paper reports that glucagon increases fatty acid oxidation in primary human hepatocytes. ‘Glucagon-based pharmacological therapy’ describes hypolipidemic effects and suggests a possible treatment for fatty liver, but that treatment evidence comes from cattle and requires verification in nonruminants. The paper does not establish therapeutic benefit for MASLD or MASH specifically. (LLM, conf=0.86)
Experimental — accuracy not yet measuredGlucagon is secreted from pancreatic α-cells and its main physiological site of action is the liver to increase hepatic glucose production.
“Glucagon is secreted from the pancreatic a-cells and the main physiological site of action is the liver to increase hepatic glucose production [60].”
From What is the pipeline for future medications for obesity? (2025) · cites this paper as [60]
Glucagon has additional metabolic effects including increasing satiety, reducing food intake, effects on lipid homeostasis and increasing energy expenditure.
“Beyond the role of glucagon in glucose homeostasis, there are additional metabolic effects; these include increasing satiety and reducing food intake, as well as effects on lipid homeostasis and the increase of energy expenditure [8,9].”
The rationale for GLP-1/glucagon receptor dual agonists is to combine GLP-1 glucoregulatory and metabolic effects with glucagon catabolic actions in the liver to achieve greater weight loss in type 2 diabetes and obesity than GLP-1 receptor agonists alone.
“the rationale for this drug class centres around combining the robust glucoregulatory and metabolic effects of GLP-1 with the catabolic actions of glucagon in the liver with the goal of achieving more substantial body weight loss in T2D and obesity (Figure 1) 43 than with GLP-1RAs alone.”
From Management of type 2 diabetes, obesity, or nonalcoholic steatohepatitis with high‐dose GLP‐1 receptor agonists and GLP‐1 receptor‐based co‐agonists (2024) · cites this paper as [43]
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“Therefore, glucagon acts not only to increase glucose production but also to induce lipolysis, fatty acid oxidation, ketogene-sis, increase thermogenesis and energy expenditure, bile acid synthesis, and finally induce satiation and reduce food intake [22, 23].”
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“Beyond the role of glucagon in glucose homeostasis, there are additional metabolic effects; these include increasing satiety and reducing food intake, as well as effects on lipid homeostasis and the increase of energy expenditure [8,9].”
BackgroundIs Glucagon Receptor Activation the Thermogenic Solution for Treating Obesity?
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“This combination is of interest because here the GLP-1 effects are combined with the effects of glucagon in the liver with stimulation of beta-oxidation of lipids and inhibition of de novo lipogenesis in the liver [99,100].”
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Higher endogenous glucose production during OGTT vs isoglycemic intravenous glucose infusion
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- Authors
- Habegger, K. M., Heppner, K. M., Geary, N., Bartness, T. J., DiMarchi, R., & Tschöp, M. H.
- Affiliations
- University of Cincinnati (US)
- ETH Zurich (CH)
- Georgia State University (US)
- Indiana University Bloomington (US)
- Corresponding author
- Tschöp, Matthias H.
- Venue
- Nature Reviews Endocrinology
- Published
- 2010-10-19
- Volume
- 6
- Issue
- 12
- Pages
- 689-697
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- PMC
- PMC3563428
- OpenAlex
- W2068226015
- Cited by
- 406
- References
- 129
- Citations by year
- 2026: 20 · 2025: 33 · 2024: 36 · 2023: 47 · 2022: 36 · 2021: 35 · 2020: 21 · 2019: 37 · 2018: 26 · 2017: 22 · 2016: 23 · 2015: 20 · 2014: 14 · 2013: 21 · 2012: 10
- FWCI
- 1.16
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Site cant be reached (submittedVersion)
- Funders
- National Institutes of Health (5r01dk077975-05)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK-077975)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- glucagon, GLP-1 receptor, insulin, lipid metabolism, energy balance, energy expenditure, satiety, anti-obesity, dyslipidemia, obesity, metabolic syndrome, adipose tissue mass, dietary intake
- MeSH terms
- Adipose Tissue, Animals, Energy Metabolism, Glucagon, Humans, Metabolism, Models, Biological, Obesity, Lipid Metabolism
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 ›
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