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