Update on the synergistic effect of HSL and insulin in the treatment of metabolic disorders.
Level 5 - mechanism / opinion, no new human data
Narrative review and mechanism-based reasoning synthesizing animal, cellular, and human literature
PubMed 31565213 · doi:10.1177/2042018819877300
What was done
This is a narrative review synthesizing literature on the mechanistic relationships and bidirectional regulation between hormone-sensitive lipase (HSL) and insulin in lipid metabolism and metabolic disorders.
What was found
The abstract provides no numerical data. It qualitatively reports that insulin regulates HSL via transcriptional changes, post-transcriptional phosphorylation through PKA and endothelin-1, and indirect regulation via growth hormone. Insulin injection in patients rapidly increases HSL during insulin-induced hypoglycemia. Hereditary HSL deficiency in humans and experimental HSL deletion in animals disrupt insulin signaling pathways, leading to insulin resistance, diabetes, and fatty liver.
Why it matters
It highlights that the relationship between HSL and insulin is bidirectional rather than simple unidirectional inhibition, challenging classical models of lipolysis to guide drug target discovery.
Limits
This is a non-systematic narrative review providing no primary quantitative data or statistical pooling. It combines mechanistic, animal knockout, and observational human data without quality appraisal.
Cited by
- supports Elevated insulin prevents ketosis by suppressing hormone-sensitive lipase, blocking the release of free fatty acids from adipocytes.