Liver

Although hepatic glucose uptake is not dependent on insulin, it accounts for approximately 30% of insulin-mediated glucose binding throughout the body. Insulin is essential for key metabolic processes. Intracellular signaling stimulates glycogen synthesis, while protein synthesis and lipoprotein metabolism are modulated and gluconeogenesis and ketone body production are inhibited. The mitogenic effect of insulin (and growth hormone) is mediated by the hepatic production of insulin-like growth factors.

Alterations in lipoprotein metabolism are the main hepatic manifestation of insulin resistance. Increased supply of free fatty acids and reduced catabolism by adipocytes (liver cells) resistant to insulin results in increased content of triglycerides in the liver and secretion of free fatty acids. Hepatic synthesis of C-reactive protein, fibrinogen and PAI-1 is induced in response to adipocyte-derived pro-inflammatory cytokines.

Source: Wilcox G. Clin Biochem Rev. 2005 May;26(2):19-39. PMID: 16278749; PMCID: PMC1204764.