The central role of fat and effect of peroxisome proliferator-activated receptor-gamma on progression of insulin resistance and cardiovascular disease. Am J Cardiol 92:3J-9J

Division of Endocrinology, Diabetes, and Hypertension, University of California-Los Angeles School of Medicine, Los Angeles, California 90095-7073, USA.
The American Journal of Cardiology (Impact Factor: 3.28). 09/2003; 92(4A):3J-9J. DOI: 10.1016/S0002-9149(03)00610-6
Source: PubMed


Recent evidence suggests that progression of insulin resistance parallels progression of atherosclerosis. Fat plays an integral role in the development of type 2 diabetes and vascular injury. The balance of adipose-derived substances, including free fatty acids, tumor necrosis factor-alpha, leptin, adiponectin, and plasminogen activator inhibitor-1, determine both insulin action and the state of vascular inflammation. Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) ligands promote the balance of these substances to enhance insulin-mediated glucose uptake and decrease inflammation. PPAR-gamma ligands reverse the major defect of the insulin resistance syndrome and have important effects that inhibit atherosclerosis, improve endothelial cell function, and attenuate inflammation. Although more research is needed, data suggest that PPAR-gamma ligands may prevent the progression of insulin resistance to diabetes and endothelial dysfunction to atherosclerosis.

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    • "Thiazolidinediones (TZDs) are synthetic ligands also known as glitazones (troglitazone, rosiglitazone, or pioglitazone ) [1], which can bind and activate the nuclear receptor , peroxisome proliferator-activated receptor (PPAR) [2]. By binding to PPARg, TZDs are implicated in the transcription of several factors involved in the regulation of glucose and lipid metabolism, mainly in the adipose and muscle tissues [3] [4]. Recent studies showed PPARg expression in the ovary and indicated an important role for this receptor in ovarian functions such as steroid synthesis, angiogenesis, tissue remodeling, cell-cycle regulation, and apoptosis [5] [6]. "
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    • "Discovery of this unique property of telmisartan has attracted attention because of its therapeutic potential in elderly patients with obesity, metabolic syndrome, and type 2 diabetes. Several studies have shown that PPARγ plays an important role as a regulator of carbohydrate and lipid metabolism,70,71 and ligands for PPARγ improve insulin sensitivity,72 reduce triglyceride levels,72 decrease risk of atherosclerosis,73 reduce vascular and cardiac effects of hypertension,74 and promote peripheral vasodilation.75–77 "
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