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char = u;code = 117
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char = c;code = 99
char = e;code = 101
char = :;code = 58
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = t;code = 116
char = a;code = 97
char = b;code = 98
char = o;code = 111
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char = c;code = 99
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char = w;code = 119
char = a;code = 97
char = y;code = 121
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char = c;code = 99
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char = o;code = 111
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char = c;code = 99
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char = i;code = 105
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char = d;code = 100
char = i;code = 105
char = s;code = 115
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = .;code = 46
result sql = Insulin resistance: a metabolic pathway to chronic liver disease.
Insulin resistance: a metabolic pathway to chronic liver disease.
char = I;code = 73
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char = s;code = 115
char = u;code = 117
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char = n;code = 110
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char = s;code = 115
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char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = (;code = 40
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char = R;code = 82
char = );code = 41
char = ;code = 32
char = i;code = 105
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char = ;code = 32
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char = h;code = 104
char = e;code = 101
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char = p;code = 112
char = a;code = 97
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char = h;code = 104
char = o;code = 111
char = p;code = 112
char = h;code = 104
char = y;code = 121
char = s;code = 115
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char = o;code = 111
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char = o;code = 111
char = g;code = 103
char = i;code = 105
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char = l;code = 108
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char = h;code = 104
char = a;code = 97
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char = l;code = 108
char = m;code = 109
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char = k;code = 107
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char = f;code = 102
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char = o;code = 111
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char = o;code = 111
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char = i;code = 105
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char = f;code = 102
char = a;code = 97
char = t;code = 116
char = t;code = 116
char = y;code = 121
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char = (;code = 40
char = N;code = 78
char = A;code = 65
char = F;code = 70
char = L;code = 76
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char = );code = 41
char = ,;code = 44
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char = o;code = 111
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char = ;code = 32
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char = e;code = 101
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char = t;code = 116
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char = m;code = 109
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char = c;code = 99
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char = s;code = 115
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = c;code = 99
char = h;code = 104
char = r;code = 114
char = o;code = 111
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char = i;code = 105
char = c;code = 99
char = ;code = 32
char = l;code = 108
char = i;code = 105
char = v;code = 118
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char = r;code = 114
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char = d;code = 100
char = i;code = 105
char = s;code = 115
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = W;code = 87
char = e;code = 101
char = s;code = 115
char = t;code = 116
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char = e;code = 101
char = s;code = 115
char = .;code = 46
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char = W;code = 87
char = e;code = 101
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char = r;code = 114
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char = t;code = 116
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char = e;code = 101
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char = f;code = 102
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char = i;code = 105
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char = o;code = 111
char = n;code = 110
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char = o;code = 111
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char = I;code = 73
char = R;code = 82
char = ,;code = 44
char = ;code = 32
char = t;code = 116
char = h;code = 104
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char = m;code = 109
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char = s;code = 115
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char = p;code = 112
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char = h;code = 104
char = o;code = 111
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char = h;code = 104
char = y;code = 121
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char = i;code = 105
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char = o;code = 111
char = g;code = 103
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char = ;code = 32
char = I;code = 73
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char = ,;code = 44
char = ;code = 32
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char = d;code = 100
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char = t;code = 116
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char = r;code = 114
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char = l;code = 108
char = e;code = 101
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = I;code = 73
char = R;code = 82
char = ;code = 32
char = i;code = 105
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char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
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char = a;code = 97
char = t;code = 116
char = h;code = 104
char = o;code = 111
char = g;code = 103
char = e;code = 101
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char = e;code = 101
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char = i;code = 105
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = c;code = 99
char = h;code = 104
char = r;code = 114
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char = i;code = 105
char = c;code = 99
char = ;code = 32
char = l;code = 108
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char = a;code = 97
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char = .;code = 46
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char = a;code = 97
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char = e;code = 101
char = d;code = 100
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char = f;code = 102
char = r;code = 114
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char = e;code = 101
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char = a;code = 97
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char = t;code = 116
char = y;code = 121
char = ;code = 32
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char = c;code = 99
char = i;code = 105
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char = f;code = 102
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char = x;code = 120
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char = r;code = 114
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char = m;code = 109
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char = d;code = 100
char = i;code = 105
char = p;code = 112
char = o;code = 111
char = s;code = 115
char = e;code = 101
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char = t;code = 116
char = i;code = 105
char = s;code = 115
char = s;code = 115
char = u;code = 117
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
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char = o;code = 111
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char = a;code = 97
char = d;code = 100
char = i;code = 105
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char = o;code = 111
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char = g;code = 103
char = a;code = 97
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char = ,;code = 44
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char = l;code = 108
char = t;code = 116
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char = a;code = 97
char = l;code = 108
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char = f;code = 102
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char = ;code = 32
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char = e;code = 101
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char = s;code = 115
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char = c;code = 99
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char = g;code = 103
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result sql = Insulin resistance (IR) is the pathophysiological hallmark of nonalcoholic fatty liver disease (NAFLD), one of the most common causes of chronic liver disease in Western countries. We review the definition of IR, the methods for the quantitative assessment of insulin action, the pathophysiology of IR, and the role of IR in the pathogenesis of chronic liver disease. Increased free fatty acid flux from adipose tissue to nonadipose organs, a result of abnormal fat metabolism, leads to hepatic triglyceride accumulation and contributes to impaired glucose metabolism and insulin sensitivity in muscle and in the liver. Several factors secreted or expressed in the adipocyte contribute to the onset of a proinflammatory state, which may be limited to the liver or more extensively expressed throughout the body. IR is the common characteristic of the metabolic syndrome and its related features. It is a systemic disease affecting the nervous system, muscles, pancreas, kidney, heart, and immune system, in addition to the liver. A complex interaction between genes and the environment favors or enhances IR and the phenotypic expression of NAFLD in individual patients. Advanced fibrotic liver disease is associated with multiple features of the metabolic syndrome, and the risk of progressive liver disease should not be underestimated in individuals with metabolic disorders. Finally, the ability of insulin-sensitizing, pharmacological agents to treat NAFLD by reducing IR in the liver (metformin) and in the periphery (thiazolidinediones) are discussed.

Publication: Hepatology 2005 Nov ;42(5)::987-1000.
Publication Date: 2005 Nov
Study Author(s): Bugianesi, Elisabetta;McCullough, Arthur J;Marchesini, Giulio;
Institution: Gastroenterology Department, University of Turin, Turin, Italy.
Shortcut link to this study:
Insulin resistance (IR) is the pathophysiological hallmark of nonalcoholic fatty liver disease (NAFLD), one of the most common causes of chronic liver disease in Western countries. We review the definition of IR, the methods for the quantitative assessment of insulin action, the pathophysiology of IR, and the role of IR in the pathogenesis of chronic liver disease. Increased free fatty acid flux from adipose tissue to nonadipose organs, a result of abnormal fat metabolism, leads to hepatic triglyceride accumulation and contributes to impaired glucose metabolism and insulin sensitivity in muscle and in the liver. Several factors secreted or expressed in the adipocyte contribute to the onset of a proinflammatory state, which may be limited to the liver or more extensively expressed throughout the body. IR is the common characteristic of the metabolic syndrome and its related features. It is a systemic disease affecting the nervous system, muscles, pancreas, kidney, heart, and immune system, in addition to the liver. A complex interaction between genes and the environment favors or enhances IR and the phenotypic expression of NAFLD in individual patients. Advanced fibrotic liver disease is associated with multiple features of the metabolic syndrome, and the risk of progressive liver disease should not be underestimated in individuals with metabolic disorders. Finally, the ability of insulin-sensitizing, pharmacological agents to treat NAFLD by reducing IR in the liver (metformin) and in the periphery (thiazolidinediones) are discussed.
PMID: 16250043

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