Sodium-glucose Cotransporter 2 Inhibitors and Nonalcoholic Fatty Liver Disease.

ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) is a systemic disorder with cardiovascular manifestations; due to its complex and multifactorial pathophysiological mechanisms, no effective pharmacologic treatment has been identified to date. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated potentially favorable effects on NAFLD incidence and progression in preclinical and clinical studies. This review summarizes the evidence from preclinical and human studies supporting the use of SGLT2 inhibitors in NAFLD and proposes several mechanisms that may drive these favorable effects (ie, increasing insulin sensitivity, decreasing intrahepatic fat accumulation and lipotoxicity, decreasing oxidative stress and endoplasmic reticulum (ER) stress, improving autophagy, and inhibiting apoptosis).