Fig. 2.

The liver-protecting actions of telmisartan in NAFLD are shown. Telmisartan blocks the AT1R, inhibits the ACE/Ang II/AT1R axis and stimulates the Ang-(1–7)/Mas axis of RAS, improves insulin sensitivity, lipid metabolism, and decreases the expression of proinflammatory cytokines, with the suppression of macrophage infiltration into the liver. The result is morphological improvement in hepatic steatosis and in fibrogenic markers. Telmisartan also has anti-oxidative properties and works as a partial agonist of the nuclear receptor PPAR-γ, an action that contributes to increase insulin sensitivity and decrease inflammation, oxidative stress, cell proliferation, and fatty acid/triglyceride levels