肝硬化病人胰岛素抵抗的研究进展

The new developments on insulin resistance in liver cirrhosis

胰岛素抵抗是指肝脏、骨骼肌、脂肪等组织对胰岛素作用的敏感性下降。肝硬化病人经常会伴随胰岛素抵抗和糖耐量减退。尽管其机制尚不明确,但很多的研究表明肝硬化病人胰岛素抵抗的发生可能与肝硬化时肝脏病理生理的改变、胰岛素与其受体的亲和力降低、拮抗胰岛素的相关激素增加,血内游离脂肪酸增加,血清胰岛素样生长因子水平升高以及调控糖代谢的相关基因表达异常有关。就肝硬化胰岛素抵抗的相关因素作一综述。

Insulin resistance refers that the reduced response of liver, skeletal muscle and adipose to insulin. Cirrhosis is often associated with insulin resistance, which glucose tolerance. Although the underlying mechanism is not completely clear, several studies have shown that it is related to the physiopathologic alteration to liver cirrhosis, the low affinity between insulin and its receptor, the in- crease of anti - insulin hormones and free fatty acid in blood, the augmentation of insulin - like growth factor and the abnormal regulatory glycometabolic gene expression. This review outlines the possible mechanisms underlying insulin resistance of cirrhosis.