PPAR agonists for the treatment of cardiovascular disease in patients with Diabetes

Abstract

Abstract
Background: PPAR agonists are drugs that act upon peroxisome proliferator-activated receptors. They are used for treating symptoms like metabolic syndrome, especially for lowering triglycerides and blood sugar.
Objective: PPAR mediated treatment in type 2 diabetes patients and has certain cardiovascular benefits at the post-ischemic stroke. In the Asian diabetic and Hypertension case, patients have additional help from the PPAR therapy for an unknown reason. The objective of this study is to find out the Pioglitazone treatment effectiveness in the patient’s body.
Methods: Between 2008 and 2020, admitted patients for ischemic stroke from Taiwan's National health insurance research database were studied. Type II Diabetes mellitus and hypertension patients were also included. Patients were grouped into Pioglitazone and Non-Pioglitazone based on treatment. A propensity score for balancing the baseline characteristics, medication and severe stroke was used. The significant result was achieved for the recurrent ischemic stroke. Subgroup analysis is done in the recurrent ischemic stroke in Pioglitazone and Telmisartan treated patients. Further trend analysis was done for the ischemic stroke risk patients, and a dose-dependent result for the different pioglitazone possession ratio was done under significance level <0.1 and <0.05, respectively.
Results: In the Pioglitazone group, there were 3190 patients, and in the non-Pioglitazone group, there were 32645 patients. Pioglitazone treated patients have a low risk for the Ischemic stroke, as compared to the recurrent and non-Pioglitazone treated group (0.91 sub-distribution hazard ratio; and Confidence interval level is 0.84 to 0.99). Pioglitazone related to the reduced ischemic stroke (p-value for interaction is 0.071). A correlation was found between the PPAR- gamma treatment and ischemic stroke (p-value is 0.076). The dose-specific result also proved that a significant relationship of Pioglitazone in increasing dose causes less recurrent Ischemic stroke (p value=0.068)
Conclusions: According to this study, Pioglitazone treatment in type 2 diabetes patients and hypersensitive Ischemic stroke patients is linked to minor ischemic stroke which is recurrent in Asian people. Pioglitazone and the telmisartan treatment have an increasing pleiotropic effect related to the higher PPAR- gamma effects. Further research needs to be conducted with the PPAR mechanism's details to confirm the PPAR effect on Ischemic stroke treatment. [Ethiop. J. Health Dev. 2021; 35(3): 249-257]
Keywords: PPAR agonist, Dyslipidaemia, Thiazolidinediones, Type 2 diabetes, Pioglitazone, PPAR-alpha, PPAR-gamma, Insulin resistance, Alecardio.