Skip to content

Research at St Andrews

The clinical significance of PPAR gamma agonism

Research output: Contribution to journalReview article

Author(s)

School/Research organisations

Abstract

Insulin resistance is a principal underlying defect in type 2 DM along with beta-cell dysfunction, and this insulin resistance underpins many of the abnormalities associated with the metabolic syndrome. Peroxisome-proliferator-activated receptor gamma agonists (PPARγ agonists), also known as glitazones or thiazolidinediones (TZDs) are powerful insulin sensitisers with recent evidence suggesting that they also have a potential to improve pancreatic beta-cell function.

TZDs cause a major redistribution of body fat with a decrease in visceral and hepatic fat content with a resultant increase in insulin sensitivity. The glucose lowering effects of TZDs are similar to those seen with the well-established sulphonylureas and metformin. TZDs have a small reducing effect on blood pressure and have been shown to reduce microalbuminuria independent of their blood glucose lowering effect. Both TZDs in clinical practice, pioglitazone and rosiglitazone, reduce small dense LDL-cholesterol and increase HDL-cholesterol levels but pioglitazone would appear to have a more pronounced benefit on these two parameters with a greater reduction in plasma triglycerides. TZDs improved the pro-coagulant state and show benefits in improving endothelial dysfunction and reducing 'non-traditional' inflammatory cytokines and increasing adiponectin levels. The greatest benefit for the TZDs is to directly influence atherogenesis itself and the potential that these so-called pleiotrophic effects of TZDs to reduce cardiovascular events in type 2 DM will be tested when the results of outcome trials are published in the next few years. If the results are positive for the reduction in vascular end-points, then TZDs will represent a major advance in improving the prognosis of type 2 DM subjects with the metabolic syndrome.

Close

Details

Original languageEnglish
Pages (from-to)349-363
Number of pages15
JournalCurrent Molecular Medicine
Volume5
Publication statusPublished - May 2005

    Research areas

  • TYPE-2 DIABETES-MELLITUS, CORONARY-ARTERY-DISEASE, PLASMINOGEN-ACTIVATOR INHIBITOR-1, ABDOMINAL FAT DISTRIBUTION, INSULIN-RESISTANCE, GLYCEMIC CONTROL, MICROVASCULAR COMPLICATIONS, CARDIOVASCULAR-DISEASE, METABOLIC SYNDROME, BLOOD-PRESSURE

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Metformin and cardiorenal outcomes in diabetes: a reappraisal

    Petrie, J. R., Rossing, P. R. & Campbell, I. W., 18 Feb 2020, In : Diabetes, Obesity and Metabolism. Early View

    Research output: Contribution to journalReview article

  2. A case of reversible amnesia - Hashimoto's encephalopathy

    Stone, J., Campbell, I. W., Moran, G. D. & Mumford, C. J., Jan 2001, In : Postgraduate Medical Journal. 77, p. 54 4 p.

    Research output: Contribution to journalArticle

ID: 705210

Top