Thiazolidinediones and PPARγ agonists: time for a reassessment

被引:334
作者
Cariou, Bertrand [1 ,2 ,3 ]
Charbonnel, Bernard [2 ,3 ]
Staels, Bart [4 ,5 ,6 ]
机构
[1] INSERM, Unite Mixte Rech 1087, F-44000 Nantes, France
[2] Ctr Hosp Univ CHU Nantes, Clin Endocrinol, Inst Thorax, F-44000 Nantes, France
[3] Univ Nantes, Fac Med, F-44000 Nantes, France
[4] Univ Lille Nord France, F-59019 Lille, France
[5] Inst Pasteur, INSERM, Unite Mixte Rech 1011, F-59019 Lille, France
[6] Univ Lille 2, F-59019 Lille, France
关键词
HEPATIC INSULIN SENSITIVITY; TYPE-2; DIABETES-MELLITUS; PIOGLITAZONE CLINICAL-TRIAL; FATTY LIVER IMPROVEMENT; INTIMA-MEDIA THICKNESS; MYOCARDIAL-INFARCTION; HEART-FAILURE; DOUBLE-BLIND; NONALCOHOLIC STEATOHEPATITIS; CARDIOVASCULAR-DISEASE;
D O I
10.1016/j.tem.2012.03.001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Thiazolidinediones (TZDs) are anti-diabetic drugs that act as insulin sensitizers and are used in the management of type 2 diabetes mellitus. TZDs, which are ligands for the transcription factor peroxisome proliferator-activated receptor PPAR gamma, have a wide spectrum of action, including modulation of glucose and lipid homeostasis, inflammation, atherosclerosis, bone remodeling and cell proliferation. Randomized clinical trials have demonstrated the efficacy and durability of the anti-hyperglycemic action of TZDs, and have suggested that the TZD pioglitazone also exerts cardioprotective action. However, the clinical use of TZDs is limited by the occurrence of several adverse events, including body-weight gain, congestive heart failure, bone fractures and possibly bladder cancer. Therefore, there is an unmet need for the development of new safer PPAR gamma-modulating drugs.
引用
收藏
页码:205 / 215
页数:11
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