[HTML][HTML] SGLT2 inhibition by empagliflozin promotes fat utilization and browning and attenuates inflammation and insulin resistance by polarizing M2 macrophages in …

L Xu, N Nagata, M Nagashimada, F Zhuge, Y Ni… - …, 2017 - thelancet.com
L Xu, N Nagata, M Nagashimada, F Zhuge, Y Ni, G Chen, E Mayoux, S Kaneko, T Ota
EBioMedicine, 2017thelancet.com
Abstract Sodium-glucose cotransporter (SGLT) 2 inhibitors increase urinary glucose
excretion (UGE), leading to blood glucose reductions and weight loss. However, the impacts
of SGLT2 inhibition on energy homeostasis and obesity-induced insulin resistance are less
well known. Here, we show that empagliflozin, a SGLT2 inhibitor, enhanced energy
expenditure and attenuated inflammation and insulin resistance in high-fat-diet-induced
obese (DIO) mice. C57BL/6J mice were pair-fed a high-fat diet (HFD) or a HFD with …
Abstract
Sodium-glucose cotransporter (SGLT) 2 inhibitors increase urinary glucose excretion (UGE), leading to blood glucose reductions and weight loss. However, the impacts of SGLT2 inhibition on energy homeostasis and obesity-induced insulin resistance are less well known. Here, we show that empagliflozin, a SGLT2 inhibitor, enhanced energy expenditure and attenuated inflammation and insulin resistance in high-fat-diet-induced obese (DIO) mice. C57BL/6J mice were pair-fed a high-fat diet (HFD) or a HFD with empagliflozin for 16weeks. Empagliflozin administration increased UGE in the DIO mice, whereas it suppressed HFD-induced weight gain, insulin resistance, and hepatic steatosis. Moreover, empagliflozin shifted energy metabolism towards fat utilization, elevated AMP-activated protein kinase and acetyl-CoA carbolxylase phosphorylation in skeletal muscle, and increased hepatic and plasma fibroblast growth factor 21 levels. Importantly, empagliflozin increased energy expenditure, heat production, and the expression of uncoupling protein 1 in brown fat and in inguinal and epididymal white adipose tissue (WAT). Furthermore, empagliflozin reduced M1-polarized macrophage accumulation while inducing the anti-inflammatory M2 phenotype of macrophages within WAT and liver, lowering plasma TNFα levels and attenuating obesity-related chronic inflammation. Thus, empagliflozin suppressed weight gain by enhancing fat utilization and browning and attenuated obesity-induced inflammation and insulin resistance by polarizing M2 macrophages in WAT and liver.
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