Key result
Increases in hepatic diacylglycerol content leading to activation of protein kinase Cϵ can explain the pathogenesis of NAFLD-associated hepatic insulin resistance and type 2 diabetes.
The DAG-PKCϵ hypothesis provides a mechanistic explanation for the development of hepatic insulin resistance in NAFLD associated with obesity, lipodystrophy, and type 2 diabetes.
Supports DAG-PKCε mediation of NAFLD insulin resistance; leaves open interventional trials before clinical adoption.
Nonalcoholic fatty liver disease (NAFLD), hepatic insulin resistance, and type 2 diabetes are all strongly associated and are all reaching epidemic proportions. Whether there is a causal link between NAFLD and hepatic insulin resistance is controversial. This review will discuss recent studies in both humans and animal models of NAFLD that have implicated increases in hepatic diacylglycerol (DAG) content leading to activation of novel protein kinase Cϵ (PKCϵ) resulting in decreased insulin signaling in the pathogenesis of NAFLD-associated hepatic insulin resistance and type 2 diabetes. The DAG-PKCϵ hypothesis can explain the occurrence of hepatic insulin resistance observed in most cases of NAFLD associated with obesity, lipodystrophy, and type 2 diabetes.
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Birkenfeld et al. (2013) conducted a review in Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 diabetes. Increases in hepatic diacylglycerol content leading to activation of protein kinase Cϵ can explain the pathogenesis of NAFLD-associated hepatic insulin resistance and type 2 diabetes.
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