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. 2023 Jun 22;72(9):1214–1227. doi: 10.2337/db23-0089

Figure 8.

Figure 8

Summary of the effects of metformin on the fetal liver. The fetal liver has abundant OCT1 uptake transporter expression and metformin uptake in vivo. In the fetal hepatocyte, metformin (1) suppresses oxygen consumption and energy production (2). Metformin activates AMPK, which disrupts metabolism and causes a shift from anabolic to catabolic pathways (3). Metformin induces activation of stress pathways including NRF-2, eIF2α, CREB, and PGC-1α (4). Metformin alters the synthesis of secreted factors (hepatokines).