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Year : 2012  |  Volume : 3  |  Issue : 1  |  Page : 2

Peroxisome Proliferators Activated Receptor-γ Agonists: Pioglitazone and Telmisartan; potential therapeutic approaches to the Metabolic Syndrome

Associate Professor, Department of Medicine, J.N. Medical College &Hospital AMU, Aligarh -202002, India

Correspondence Address:
S F Haque
Associate Professor, Department of Medicine, J.N. Medical College &Hospital AMU, Aligarh -202002, India

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Source of Support: None, Conflict of Interest: None

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At the crossroads of obesity, insulin resistance, and cardiovascular disease, is the nuclear receptor PPAR-γ. The modulation of PPAR-gamma activity is an interesting therapeutic approach to address multi-component metabolic syndrome. Any therapy that targets all the components of the metabolic syndrome is either non-existent or ineffective. Pioglitazone, a glitazone and Telmisartan, an angiotensin receptor blocker, share the unique property of activating PPAR-γ. Both have the potential to treat the hemodynamic, biochemical and inflammatory components of metabolic syndrome. To evaluate the efficacy of two PPAR-γ agonists; Pioglitazone and Telmisartan in treating multiple components of metabolic syndrome. This parallel group, interventional, randomized, open-labeled, active controlled comparative study, in patients having 3/5 NCEP-ATP III criteria was conducted at a University hospital. Changes in various hemodynamic and biochemical parameters along with hs-CRP, TNF-a, IL-6, at baseline and at 24 weeks, in the control group (n=20), Pioglitazone group (n=30) 30mg/day & Telmisartan group (n=30) 40mg/day, were studied. Analysis was done with Graph Pad Prism 5.0, two tailed p of <0.05 was considered significant (95% C.I). No statistically significant differences between the groups in various parameters were observed at baseline. Elevated waist circumference (WC), hypertension and diabetes mellitus were the most prevalent combination. Both Pioglitazone and Telmisartan were equally effective in reducing the WC, diastolic blood pressure and triglyceride. Pioglitazone was more effective in correcting hyperglycaemia, and Systolic Blood Pressure was more significantly reduced by Telmisartan. CRP and IL-6 were significantly and TNF-α was insignificantly reduced by telmisartan, vis-a-vis Pioglitazone. The present study provides the evidence of an anti-inflammatory and anti-atherogenic effect of PPAR-γ agonists: Pioglitazone and Telmisartan. The targeted treatment by PPAR-γ agonists is an effective monotherapy option in metabolic syndrome.

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