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Proc Natl Acad Sci USA 2013

Use of COMT inhibitors, especially entacapone, was associated with reduction in abundance of Firmicutes , species Faecalibacterium prausnitzii [68, 69] and Lachnospiraceae [68, 70], and increased abundance of Actinobacteria , Lactobacillaceae , Porphyromonadaceae and Proteobacteria [68]

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This leads to peripheral and hepatic insulin resistance and compensatory intra-portal hyperinsulinemia, which results in increased hepatic GH sensitivity that aggravates the condition further ( Table 1

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