Glucagon resistance and metabolic-associated steatotic liver disease: a review of the evidence
Author(s)
McGlone, Emma Rose
Bloom, Stephen R
Tan, Tricia M-M
Type
Journal Article
Abstract
Metabolic-associated steatotic liver disease (MASLD) is closely associated with obesity. MASLD affects over 1 billion adults globally but there are few treatment options available. Glucagon is a key metabolic regulator, and its actions include the reduction of liver fat through direct and indirect means. Chronic glucagon signalling deficiency is associated with hyperaminoacidaemia, hyperglucagonaemia and increased circulating levels of glucagon-like peptide 1 (GLP-1) and fibroblast growth factor 21 (FGF-21). Reduction in glucagon activity decreases hepatic amino acid and triglyceride catabolism; metabolic effects include improved glucose tolerance, increased plasma cholesterol and increased liver fat. Conversely, glucagon infusion in healthy volunteers leads to increased hepatic glucose output, decreased levels of plasma amino acids and increased urea production, decreased plasma cholesterol and increased energy expenditure. Patients with MASLD share many hormonal and metabolic characteristics with models of glucagon signalling deficiency, suggesting that they could be resistant to glucagon. Although there are few studies of the effects of glucagon infusion in patients with obesity and/or MASLD, there is some evidence that the expected effect of glucagon on amino acid catabolism may be attenuated. Taken together, this evidence supports the notion that glucagon resistance exists in patients with MASLD and may contribute to the pathogenesis of MASLD. Further studies are warranted to investigate the direct effects of glucagon on metabolism in patients with MASLD.
Date Issued
2024-06-01
Date Acceptance
2024-04-03
Citation
Journal of Endocrinology, 2024, 261 (3)
ISSN
0022-0795
Publisher
BioScientifica
Journal / Book Title
Journal of Endocrinology
Volume
261
Issue
3
Copyright Statement
© 2024 the author(s). This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/)
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/38579751
PII: JOE-23-0365
Subjects
Animals
Fatty Liver
Fibroblast Growth Factors
Glucagon
Glucagon-Like Peptide 1
Humans
Liver
Obesity
glucagon
glucagon resistance
glucagon-like peptide 1
metabolic dysfunction-associated steatotic liver disease (MASLD)
non-alcoholic fatty liver disease (NAFLD)
Publication Status
Published
Coverage Spatial
England
Article Number
e230365