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The mechanism of action of Thiozolidinediones (also called Glitazones) Frequently tested in USMLE Step 1 and so here's a quick bulleted points:

  • Insulin resistance is decreased (Adiponectin increased and resistin decreased).
  • Adipocyte maturation is stimulated.
  • Leptin secretion is inhibited (causing increased appetite).
  • Hepatic gluconeogensis is inhibited.
  • Glut 1 and Glut 4 receptor expression is increased.
  • Free fatty acids, triglycerides, and C reactive protein decrease (cardioprotective).

Most of these actions are mediated via activation of peroxisome proliferator activating receptors (PPAR).
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