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Hepatic insulin resistance and altered insulin metabolism, as
characterised by the desensitisation of hepatic parenchymal cells
to insulin, play a role in the pathogenesis of liver disease,
particularly resulting in steatosis and steatohepatitis. By the
same token, type II diabetic patients are at higher risk for
developing liver diseases, including steatosis, hepatitis,
cirrhosis, and hepatocellular carcinoma. On the other hand,
established liver disease from any cause leads to glucose
intolerance and peripheral insulin resistance systemically. The
link between insulin resistance and liver pathology reviewed in
this book suggests that insulin resistance is closely related with
a variety of liver diseases. Recent evidence indicates that the AMP
activating protein kinase (AMPK) in conjunction with p70 ribosomal
S6 kinase 1 (S6K1) serves as a key signalling pathway regulating
insulin-dependent physiological functions; thus, this pathway
serves as a target for the therapy of diseases associated with
insulin resistance. In this chapter, the regulatory role of the
AMPK-S6K1 pathway is discussed in terms of enhancing insulin
receptor signalling with insulin receptor substrate-1/2 and
phosphatidylinositol phosphate kinase activity, which may
contribute to preventing and/or treating insulin resistance in the
liver.
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