胆汁酸与胰岛素抵抗(非酒精性脂肪肝)2009

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1、JournalofDigestiveDiseases2009;10;85–90doi:10.1111/j.1751-2980.2009.00369XXXBlackwellPublishingAsiaReviewArticleMelbourne,AustraliaBileacidsandnonalcoholicfattyliverdiseaseCDDJWeiChineseJournalofDigestiveDiseases1443-96111751-2980©2009TheAuthorsJournalcompilation©2009ChineseMedicalAssociat

2、ionShanghaiBranch,ChineseSocietyofGastroenterologyandBlackwellPublietal.Bileacidsandinsulinresistance:implicationsfortreatingshingAsiaPtyLtd.nonalcoholicfattyliverdiseaseJueWEI,*DeKaiQIU&XiongMADepartmentofGastroenterology,RenjiHospital,ShanghaiJiaotongUniversitySchoolofMedicine,ShanghaiIn

3、stituteofDigestiveDisease,Shanghai,ChinaNonalcoholicfattyliverdiseaseischaracterizedbyanrecyclingandbiosynthesisofbileacidsandunderliesaccumulationofexcesstriglyceridesinhepatocytes,thedown-regulationofhepaticfattyacidandtriglycerideandinsulinresistanceisnowconsideredthefunda-biosynthesisa

4、ndverylowdensitylipoproteinproduc-mentaloperativemechanismthroughoutthepreva-tionmediatedbysterol-regulatoryelement-bindinglenceandprogressionofthedisease.Besidestheirroleprotein-1c.Thebileacid-TGR5-cAMP-D2signalingindietarylipidabsorptionandcholesterolhomeosta-pathwayinhumanskeletalmuscle

5、inthefasting–sis,evidencehasaccumulatedthatbileacidsarealsofeedingcycleincreasesenergyexpenditureandpreventssignalingmoleculesthatplaytwoimportantrolesinobesity.Therefore,amolecularbasishasbeenprovidedglucoseandlipidmetabolism:inthenuclearhormoneforalinkbetweenbileacids,lipidmetabolismandr

6、eceptorsasfarnesoidXreceptors(FXR),aswellasglucosehomeostasis,whichcanopennovelpharma-ligandsforG-protein-coupledreceptorsTGR5.ThecologicalapproachesagainstinsulinresistanceandactivatedFXR-SHPpathwayregulatestheenterohepaticnonalcoholicfattyliverdisease.KEYWORDS:bileacid,farnesoidXreceptor

7、s,insulinresistance,nonalcoholicfattyliverdisease.metabolismofglucosethroughitseffectsonglycogenINTRODUCTION1synthase.InsulinresistancecausesbothglucoseuptakeInsulinresistanceisthebasisofmostifnotallofaandadecreaseofitsinhibitingeffectsonfreefattynumberofclini