The liver performs over 500 metabolic functions. In fact, the metabolic activity of the liver accounts for 20-30% of the oxygen consumption and energy expenditure of the body . When liver dysfunction occurs, a catabolic state is induced, and increased serum levels of insulin (often with insulin resistance), glucagon, epinephrine and cortisol are present. Because the liver is involved in the metabolism of all nutrients (Table 4.1), an alteration of liver function causes a concomitant alteration in nutrient metabolism and storage.
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