Thiazolidinediones: Potential Link Between Insulin Resistance and Cardiovascular Disease
- Vanita R. Aroda, MD and
- Robert R. Henry, MD
- Address correspondence and reprint requests to Vanita R. Aroda, MD, University of California, San Diego, VA San Diego Healthcare System, Division of Endocrinology, Diabetes, and Metabolism, 3350 La Jolla Village Drive, #111G, San Diego, CA 92161.
Abstract
The thiazolidinediones are a unique class of oral antidiabetic agents that has been shown to directly reduce insulin resistance at sites of insulin action, specifically adipose tissue, skeletal muscle, and the liver. By reducing insulin resistance, these drugs influence many of the modifiable cardiovascular risk factors associated with the insulin resistance syndrome, also known as the cardiovascular dysmetabolic syndrome. Such cardiovascular factors are involved in the development of atherosclerosis and include dyslipidemia, hypertension, microalbuminuria, impaired vascular reactivity, and impaired fibrinolysis. Whether these effects of the thiazolidinediones translate to a reduced incidence of cardiovascular events in people with type 2 diabetes remains to be seen.
Footnotes
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Vanita R. Aroda, MD, is a senior fellow in the Division of Diabetes, Endocrinology, and Metabolism at the University of California, San Diego, and the San Diego VA Healthcare System. Robert R. Henry, MD, is a professor of medicine and chief of the Section of Diabetes, Endocrinology, and Metabolism at the San Diego VA Healthcare System in La Jolla, Calif.
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Note of disclosure: Dr. Henry has received honoraria for speaking engagements, consulting fees, and research support from GlaxoSmithKline, Inc.; Takeda Pharmaceuticals North America, Inc.; and Pfizer, Inc. These companies manufacture thiazolidinediones.
- American Diabetes Association
