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钠-葡萄糖协同转运蛋白 2 抑制剂在肥胖和胰岛素抵抗中的新作用:聚焦脂肪棕色化和巨噬细胞极化。

Emerging roles of SGLT2 inhibitors in obesity and insulin resistance: Focus on fat browning and macrophage polarization.

机构信息

a Department of Cell Metabolism and Nutrition , Advanced Preventive Medical Sciences Research Center, Kanazawa University , Kanazawa, Ishikawa , Japan.

b Division of Metabolism and Biosystemic Science, Department of Medicine , Asahikawa Medical University , Asahikawa , Hokkaido , Japan.

出版信息

Adipocyte. 2018;7(2):121-128. doi: 10.1080/21623945.2017.1413516. Epub 2018 Jan 29.


DOI:10.1080/21623945.2017.1413516
PMID:29376471
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6152529/
Abstract

Obesity-associated low-grade inflammation underlies insulin resistance and associated metabolic comorbidities, such as type 2 diabetes (T2D) and nonalcoholic fatty liver disease. Excessive ectopic fat deposition in obesity causes disorders of energy homeostasis and low-grade chronic inflammation in metabolic tissues. In particular, obesity-induced recruitment and activation of adipose tissue macrophages play a key role in the pathogenesis of insulin resistance and T2D. Therefore, treatment options for energy metabolism and macrophage polarization in obese subjects are needed. Sodium-glucose cotransporter (SGLT) 2 inhibitors increase urinary glucose excretion by inhibiting renal glucose reabsorption, thereby having subsequent anti-hyperglycemic effects and reducing body weight. We recently reported that the SGLT2 inhibitor empagliflozin increases fat utilization and browning in white adipose tissue and attenuates obesity-induced inflammation and insulin resistance by activating M2 macrophages. Thus, this review focuses on the beneficial effects of empagliflozin in energy homeostasis and obesity-related inflammation and insulin resistance.

摘要

肥胖相关的低度炎症是胰岛素抵抗和相关代谢并发症的基础,如 2 型糖尿病(T2D)和非酒精性脂肪性肝病。肥胖症中过多的异位脂肪沉积导致能量平衡紊乱和代谢组织中的低度慢性炎症。特别是,肥胖诱导的脂肪组织巨噬细胞的募集和激活在胰岛素抵抗和 T2D 的发病机制中发挥关键作用。因此,需要针对肥胖患者的能量代谢和巨噬细胞极化的治疗选择。钠-葡萄糖共转运蛋白(SGLT)2 抑制剂通过抑制肾脏葡萄糖重吸收来增加尿葡萄糖排泄,从而具有后续的降血糖作用和减轻体重。我们最近报道,SGLT2 抑制剂恩格列净通过激活 M2 巨噬细胞增加白色脂肪组织中的脂肪利用和棕色化,并减轻肥胖引起的炎症和胰岛素抵抗。因此,本综述重点介绍了恩格列净在能量平衡和肥胖相关炎症及胰岛素抵抗方面的有益作用。

相似文献

[1]
Emerging roles of SGLT2 inhibitors in obesity and insulin resistance: Focus on fat browning and macrophage polarization.

Adipocyte. 2018-1-29

[2]
SGLT2 Inhibition by Empagliflozin Promotes Fat Utilization and Browning and Attenuates Inflammation and Insulin Resistance by Polarizing M2 Macrophages in Diet-induced Obese Mice.

EBioMedicine. 2017-5-26

[3]
Empagliflozin reverses obesity and insulin resistance through fat browning and alternative macrophage activation in mice fed a high-fat diet.

BMJ Open Diabetes Res Care. 2019-10-25

[4]
Glucoraphanin Ameliorates Obesity and Insulin Resistance Through Adipose Tissue Browning and Reduction of Metabolic Endotoxemia in Mice.

Diabetes. 2017-2-16

[5]
Ipragliflozin Improves Hepatic Steatosis in Obese Mice and Liver Dysfunction in Type 2 Diabetic Patients Irrespective of Body Weight Reduction.

PLoS One. 2016-3-15

[6]
MiR-130b promotes obesity associated adipose tissue inflammation and insulin resistance in diabetes mice through alleviating M2 macrophage polarization via repression of PPAR-γ.

Immunol Lett. 2016-12

[7]
Therapeutic Effects of SGLT2 Inhibitor Ipragliflozin and Metformin on NASH in Type 2 Diabetic Mice.

Endocr Res. 2020-1-18

[8]
Sodium glucose cotransporter 2 inhibitor dapagliflozin depressed adiposity and ameliorated hepatic steatosis in high-fat diet induced obese mice.

Adipocyte. 2021-12

[9]
Berberine, a Traditional Chinese Medicine, Reduces Inflammation in Adipose Tissue, Polarizes M2 Macrophages, and Increases Energy Expenditure in Mice Fed a High-Fat Diet.

Med Sci Monit. 2019-1-4

[10]
Ursodeoxycholic Acid Regulates Hepatic Energy Homeostasis and White Adipose Tissue Macrophages Polarization in Leptin-Deficiency Obese Mice.

Cells. 2019-3-16

引用本文的文献

[1]
Weight-independent amelioration of adipokine profile by enavogliflozin, a selective SGLT2 inhibitor, in patients with type 2 diabetes.

Cardiovasc Diabetol. 2025-8-31

[2]
Effects of Empagliflozin on Sarcopenia Risk, Body Composition, and Muscle Strength in Type 2 Diabetes: A 24-Week Real-World Observational Study.

Medicina (Kaunas). 2025-6-26

[3]
Molecular crosstalk in perivascular adipose tissue: mechanisms of inflammation, metabolic dysregulation, and therapeutic opportunities in cardiovascular disease.

Front Cardiovasc Med. 2025-6-26

[4]
SGLT2 Inhibitors in Cancer Patients: A Comprehensive Review of Clinical, Biochemical, and Therapeutic Implications in Cardio-Oncology.

Int J Mol Sci. 2025-5-16

[5]
In the Era of Cardiovascular-Kidney-Metabolic Syndrome in Cardio-Oncology: From Pathogenesis to Prevention and Therapy.

Cancers (Basel). 2025-3-30

[6]
Empagliflozin Ameliorates the Oxidative Stress Profile in Type 2 Diabetic Patients with Heart Failure and Reduced Ejection Fraction: Results of a Randomized, Double-blind, Placebo-controlled Study.

Rev Recent Clin Trials. 2025

[7]
Adipokines and Cardiometabolic Heart Failure with Preserved Ejection Fraction: A State-of-the-Art Review.

Diagnostics (Basel). 2024-11-27

[8]
The Possible Associations between Tauopathies and Atherosclerosis, Diabetes Mellitus, Dyslipidemias, Metabolic Syndrome and Niemann-Pick Disease.

Diagnostics (Basel). 2024-8-22

[9]
Role and mechanism of specialized pro-resolving mediators in obesity-associated insulin resistance.

Lipids Health Dis. 2024-7-30

[10]
Therapeutic strategies targeting mechanisms of macrophages in diabetic heart disease.

Cardiovasc Diabetol. 2024-5-15

本文引用的文献

[1]
SGLT2 Inhibition by Empagliflozin Promotes Fat Utilization and Browning and Attenuates Inflammation and Insulin Resistance by Polarizing M2 Macrophages in Diet-induced Obese Mice.

EBioMedicine. 2017-5-26

[2]
The Na+/Glucose Cotransporter Inhibitor Canagliflozin Activates AMPK by Inhibiting Mitochondrial Function and Increasing Cellular AMP Levels.

Diabetes. 2016-9

[3]
Empagliflozin, via Switching Metabolism Toward Lipid Utilization, Moderately Increases LDL Cholesterol Levels Through Reduced LDL Catabolism.

Diabetes. 2016-7

[4]
Empagliflozin (BI 10773), a Potent and Selective SGLT2 Inhibitor, Induces Dose-Dependent Glucosuria in Healthy Subjects.

Clin Pharmacol Drug Dev. 2013-3-27

[5]
Sodium Intake Regulates Glucose Homeostasis through the PPARδ/Adiponectin-Mediated SGLT2 Pathway.

Cell Metab. 2016-3-24

[6]
Liver innate immune cells and insulin resistance: the multiple facets of Kupffer cells.

J Intern Med. 2016-2-11

[7]
Shift to Fatty Substrate Utilization in Response to Sodium-Glucose Cotransporter 2 Inhibition in Subjects Without Diabetes and Patients With Type 2 Diabetes.

Diabetes. 2016-5

[8]
Tofogliflozin Improves Insulin Resistance in Skeletal Muscle and Accelerates Lipolysis in Adipose Tissue in Male Mice.

Endocrinology. 2016-3

[9]
Remogliflozin Etabonate Improves Fatty Liver Disease in Diet-Induced Obese Male Mice.

J Clin Exp Hepatol. 2015-9

[10]
Treatment with the SGLT2 inhibitor luseogliflozin improves nonalcoholic steatohepatitis in a rodent model with diabetes mellitus.

Diabetol Metab Syndr. 2015-11-19

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