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Conversely, when the blood glucose levels are too high, the pancreas is signaled to release insulin. Insulin is delivered to the liver and other tissues throughout the body (e.g., muscle, adipose). When the insulin is introduced to the liver, it connects to the insulin receptors already present, that is tyrosine kinase receptor. [15]
The two primary sites for insulin clearance are the liver and the kidney. [84] It is broken down by the enzyme, protein-disulfide reductase (glutathione), [85] which breaks the disulphide bonds between the A and B chains. The liver clears most insulin during first-pass transit, whereas the kidney clears most of the insulin in systemic circulation.
In non-diabetic subjects, portal insulin concentrations are twofold to threefold greater than those in the peripheral circulation. During the first pass through the liver, 50% of the insulin is removed, strongly insinuating that the liver is the principal metabolic target organ of the gastrointestinal tract and the pancreas. The insulin ...
If the blood glucose level falls to dangerously low levels (as during very heavy exercise or lack of food for extended periods), the alpha cells of the pancreas release glucagon, a peptide hormone which travels through the blood to the liver, where it binds to glucagon receptors on the surface of liver cells and stimulates them to break down glycogen stored inside the cells into glucose (this ...
The insulin receptor (IR) is a transmembrane receptor that is activated by insulin, IGF-I, IGF-II and belongs to the large class of receptor tyrosine kinase. [5] Metabolically, the insulin receptor plays a key role in the regulation of glucose homeostasis; a functional process that under degenerate conditions may result in a range of clinical manifestations including diabetes and cancer.
The amount of glucokinase can be increased by synthesis of new protein. Insulin is the principal signal for increased transcription, operating mainly by way of a transcription factor called sterol regulatory element binding protein-1c (SREBP1c) in the liver. This occurs within an hour after a rise in insulin levels, as after a carbohydrate meal.
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The liver is the major site of first pass effect; however, it can also occur in the lungs, vasculature or other metabolically active tissues in the body. Notable drugs that experience a significant first pass effect are buprenorphine , chlorpromazine , cimetidine , diazepam , ethanol (drinking alcohol), imipramine , insulin , lidocaine ...