6. GLUCOSE BUFFER FUNCTION
Elevated
blood glucose
Liver
Glycogen
formation
Normal blood
glucose
Fall in blood
glucose
Liver Glycogenlysis
Normal blood
glucose
10. GLUCONEOGENESIS
Brain depends on glucose as its primary fuel and red
blood cells use glucose as their only fuel.
Daily requirement=160 g
Glycogen stores= 190 g of glucose
12. PROLONGED STARVATION
Depletion of glycogen stores
Fall in glucose levels
Non carbohydrate substances
lactate, amino acids, and glycerol
Gluconeogenesis in the liver and kidney
helps to maintain the glucose level in the
blood so that brain and muscle can
extract sufficient glucose from it to meet
their metabolic demands
14. OVERVIEW OF ROLE OF LIVER IN LIPID
METABOLISM
Metabolism of
Lipids
Anabolism
Synthesis of de
novo cholesterol
and fatty acids
Synthesis of fat
from proteins and
carbohydrates
Catabolism
Oxidation of fatty
acids to supply
energy for body
functions
15. DE NOVO SYNTHESIS OF CHOLESTEROL AND
FATTY ACIDS
Occurs in Liver as well as in peripheral
tissues.
For fatty acid synthesis as well as
cholesterol synthesis immediate
substrate is Acetyl CoA .
16.
17. SYNTHESIS OF FATS FROM CARBOHYDRATES
AND PROTEINS
• Acetyl CoA from
metabolism of Carbon
skeleton of proteins
• Acetyl CoA from
metabolism of
carbohydrates
Acetyl CoA enters
lipogenesis
pathway.
21. MOST IMPORTANT FUNCTIONS OF LIVER
IN PROTEIN METABOLISM
Deamination of amino acids
Formation of urea for removal of ammonia
Formation of plasma proteins
Interconversions of the various amino acids and
synthesis of other compounds from amino acids.
22. DEAMINATION OF AMINO ACIDS
Required before amino acids can be used for
energy or converted to carbohydrates or fats.
Small amount of deamination occurs in other
tissues especially in kidney
Most important site - liver.
23. UREA FORMATION
• Deamination
• In gut, by
bacteria(small
amounts)
Ammonia
Formation
• Ammonia
enters urea
cycle
Urea Formation
• Hepatic coma
• Death
avoided
Avoids ammonia
intoxication
Note: Ammonia freely permeable across blood brain barrier
Ammonia intoxication occurs in
• Severely impaired hepatic function
• Cirrhosis(Collaterals between portal and systemic veins)
26. FORMATION OF PLASMA PROTEINS
Essentially all plasma proteins, except gamma globulins.
Serum albumin quantitatively the most important
protein synthesized by the liver.
In all chronic liver diseases, serum albumin level is
decreased.
Reversal in A/G ratio occurs in liver cirrhosis, due to
hypoalbuminemia and associated
hypergammaglobulinemia.
Other plasma proteins
Acute phase proteins
Clotting factors
Transport proteins eg. For steroids, hormone transport
27. AMINO ACID METABOLISM
Synthesis of non-essential amino acids.
Keto acid having same chemical composition as that of
the amino acid to be formed is synthesized.
Transamination from an available amino acid is done.
Pyruvat
e
Alanine
Glu or Asp α-ketoglutarate or
oxaloacetete
Eg.
31. VITAMIN-A
Vitamin A is stored in greatest quantity
Maintains blood plasma levels of vitamin A
Prevents vitamin A deficiency for 10 months
MECHANISM OF UPTAKE,STORAGE AND RELEASE OF VITAMIN A
o Vitamin A (Retinol) is transported in chylomicrons as ester of fatty
acids
o Chylomicrons enter circulation;acted on by lipoprotein lipase
o Triglyceride part is reduced;retinyl ester remains unchanged
o Receptors in liver mediate uptake of chylomicron remnants.
o Chylomicron remnants are degraded and retinyl ester is stored
o Liver mobilizes vitamin A by hydrolyzing retinyl ester
o Retinol formed will be bound to retinol binding
protein(RBP),synthesized by liver
32. HYPERVITAMINOSIS- A
Develops when massive quantities of vitamin A is
consumed
Hepatotoxicity is often associated with
hypervitaminosis A
Eventually leads to portal hypertension and
cirrhosis
33. VITAMIN- D AND B12
Liver also stores vitamin D and vitamin B12
Liver helps in the activation of vitamin D.
Prevents vitamin D deficiency for 3 to 4 months.
Enough vitamin B12 can be stored in liver for
atleast 1 year.
35. IRON STORAGE IN LIVER
Liver stores iron mainly in the form of ferritin.
Iron from transferrin in blood transfers to liver and
combines with apoferritin to form ferritin.
36. WHEN BLOOD IRON LEVEL IS HIGH
Transferrin
iron in
blood
liver
Free iron
(Fe3+)
Fe3+Fe2
+
Fe2+ +
apoferritin
ferritin
37. WHEN BLOOD IRON IS LOW
Transferrin-
iron in
blood
liver
Release of
iron
Fe3+Fe2
+
Fe2+ +
apoferritin
ferritin
42. Liver detoxifies blood of substances originating
from gut or elsewhere in the body
Can be through physical methods or biochemical
reactions
Metabolites are secreted into bile and eliminated
through GIT
45. HEPATIC ENCEPHALOPATHY
Increased level of circulating ammonia due to liver
failure.
Cause-
Loss of functional hepatocytes
Shunting of portal blood
Symptoms-
Confusion
Coma and irreversible change in cognition if untreated
Hinweis der Redaktion
In patients with liver failure post prandial blood sugar rises to 2-3 times
Acp=acyl carrier protein
Deamination is done mainly from glutamate for which glutamate is formed by transamination of other amino acids
Urea cycle
Albumin level is not decreased in acute diseases as albumin has a half life of about 20 days . Prealbumin is decreased in acute hepatitis.Acute phase proteins are synthesized and secreted In response to stressful stimuli