title: Review: Miglitol has potential as a therapeutic drug against obesity.
abstract: The number of obese patients has increased annually worldwide. Therefore, there is a strong need to develop a new effective and safe anti-obesity drug. Miglitol is an alpha-glucosidase inhibitor (αGI) that is commonly used as an anti-diabetic drug, and there is growing evidence that it also has anti-obesity effects. Miglitol has been shown to reduce body weight and ameliorate insulin resistance in both clinical trials with adult patients and in rodent models of obesity. Although the specific mechanism of action of this effect remains unclear, some mechanisms have been suggested through experimental results. Miglitol has been shown to inhibit adipogenesis of white adipocytes in vitro, activate brown adipose tissue (BAT) in mice, influence bile acid metabolism in mice, and regulate the secretion of incretin hormones in humans. Among these results, we consider that BAT activation is likely the definitive mediator of miglitol's anti-obesity effect. A unique advantage of miglitol is that it is already used as an anti-diabetic drug with no severe side effects, whereas many of the anti-obesity drugs developed to date have been withdrawn because of their severe side effects. Miglitol is currently used clinically in a limited number of countries. In this review, we provide an overview of the state of research on miglitol for obesity treatment, emphasizing that it warrants more detailed attention. Overall, we demonstrate that miglitol shows good potential as a therapeutic for the treatment of obesity. Thus, we believe that further investigations of how it exerts its anti-obesity effect will likely contribute to the development of a new class of safe and effective drugs against obesity.
authors.affiliation: Department of Pediatrics, Ayabe Municipal Hospital, 20-1 Otsuka, Aono-cho, Ayabe city, 623-0011 Kyoto Japan ; Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465-Kajiicho, Hirokoji-Kawaramachi, Kamikyo-ku, Kyoto, 602-8566 Kyoto Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Sugimoto
authors.affiliation: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465-Kajiicho, Hirokoji-Kawaramachi, Kamikyo-ku, Kyoto, 602-8566 Kyoto Japan.
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Nakajima
authors.affiliation: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465-Kajiicho, Hirokoji-Kawaramachi, Kamikyo-ku, Kyoto, 602-8566 Kyoto Japan.
authors.forename: Kitaro
authors.initials: K
authors.lastname: Kosaka
authors.affiliation: Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465-Kajiicho, Hirokoji-Kawaramachi, Kamikyo-ku, Kyoto, 602-8566 Kyoto Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Hosoi
keywords: Bile acid metabolism; Brown adipose tissue; Incretin hormones; Miglitol; Obesity