Extreme liver steatosis is also associated with insulin resistance, inflammation and fibrosis in the liver, or nonalcoholic steatohepatitis.34 In KKAy mice, tofogliflozin improved hepatic steatosis, which is consistent with the effects seen in DIO mice treated with tofogliflozin24 and in nonalcoholic steatohepatitis animal models treated with another SGLT2 inhibitor.35 These results suggest that long-term administration of SGLT2 inhibitors may also prevent the progression of nonalcoholic steatohepatitis in T2D patients with obesity. Here, SLC5A2 is linked to obesity due to melanocortin 4 receptor deficiency.