Thiazolidinediones: Potential Link Between Insulin Resistance and Cardiovascular Disease

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.