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These systemic effects are crucial in the liver, where the aforementioned anti-inflammatory and anti-oxidation actions are further translated into direct improvements in lipid metabolism: by downregulating the expression of the lipid uptake receptor CD36 to inhibit lipid influx, and by reducing de novo lipogenesis through the inhibition of the expression of genes such as fatty acid synthase (FAS) and acetyl-CoA carboxylase (ACC), thereby improving fatty liver and systemic glucose-lipid metabolic homeostasis through multiple targets ( Silybin improves insulin sensitivity, protects pancreatic -cell function, regulates adipose tissue inflammation, and liver lipid metabolism through the activation of antioxidant enzymes, inhibition of the NF-B pathway, and multiple metabolic regulatory effects, collectively exerting a comprehensive benefit in improving insulin resistance and dysregulation of glucose and lipid metabolism ( Table 5 ) ( Figure 4 )

doi: 10.3390/jcm10112302 16 FerrazzoliD.CarterA.UstunF

ARB - angiotensin receptor blockers

Cell 182 , 5058.e8 (2020)