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DOX has an inhibitory effect on cardiac AMPK, which increases cardiotoxicity (122)

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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 (74)