Exploring the modulatory effects of sotagliflozin on dyslipidemia in mice: The role of glucagon, fibroblast growth factor 21 and glucagon‐like peptide 1

Abstract

AbstractSotagliflozin is the first dual SGLT1/2 inhibitor antidiabetic drug approved by the US Food and Drug Administration for the management of heart failure. SGLT1/2 inhibition is observed to potentiate the secretion of the incretin hormone, glucagon‐like peptide‐1 (GLP‐1). The current preclinical research sought to investigate the effect of sotagliflozin on the secretion of fat‐regulating peptides such as GLP‐1, glucagon and fibroblast growth factor 21 (FGF21) and their prospective association with sotagliflozin's potential beneficial effects on dyslipidaemia. During an oral fat tolerance test in mice, sotagliflozin substantially increased GLP‐1 and insulin concentrations. Although sotagliflozin alone did not ameliorate postprandial lipemia, its combination with linagliptin (DPP‐IV inhibitor) significantly improved lipid tolerance comparable to orlistat (lipase inhibitor). In a triton‐induced hypertriglyceridemia model, sotagliflozin, along with other medications (fenofibrate, exenatide and linagliptin) reduced fat excursion; however, co‐administration with linagliptin provided no extra advantage. Furthermore, sotagliflozin stimulated glucagon secretion in the alpha TC1.6 cells and healthy mice, which resulted in an increased circulating FGF21 and β‐hydroxybutyrate concentration. Finally, chronic treatment of sotagliflozin in high‐fat diet (HFD)‐fed obese mice resulted in reduced body weight gain, liver triglyceride, cholesterol, interleukin‐6 (IL‐6) and tumour necrosis factor alpha (TNF‐α) levels compared with the placebo group. However, the addition of linagliptin did not provide any additional benefit. In conclusion, sotagliflozin was found to have an effect on GLP‐1 and also stimulate the release of glucagon and FGF21, which are important for regulating fat metabolism. Therefore, sotagliflozin might represent a potential therapeutic approach for the treatment of diabetic dyslipidemia and steatohepatitis.