thiazolidinedones

Question 1

what are TZDs?

Answer 1

PPAR gamma agonists

Question 2

what is PPAR gamma?

Answer 2

a transcription factor

Question 3

what does TZD binding to PPAR gamma cause?

Answer 3

the formation of a complex with a co activator, leading to transcriptional activation of PPAR gamma target genes (there are 100s of these)

Question 4

what is the main effect of TZD?

Answer 4

on adipocytes, ultimately leading to insulin sensitivity on the liver

Question 5

what is the other name of TZDs?

Answer 5

glitazones

Question 6

where is fat mass increased as a result of TZD?

Answer 6

in subcutaneous depots and to “suck out” fat from viscera (liver and pancreas) and muscle

Question 7

does TZD lead to increased or reduced inflammatory cytokines?

Answer 7

reduced

Question 8

is adiponectin reduced as a result of TZD?

Answer 8

No

Question 9

in who are TZDs particularly effective?

Answer 9

obese women

Question 10

do TZDs lead to an increase in weight?

Answer 10

yes due to fat mass and fluid retention

Question 11

what does TZD lead to a reduction in?

Answer 11

blood pressure

Question 12

what is the only available TZD?

Answer 12

pioglitizone

Question 13

what is the normal dose of pioglitazone?

Answer 13

15-30mg od

Question 14

what are the main side effects of TZDs?

Answer 14

weight gain
fluid retention (results in peripheral oedema and doubles risk of hospitalisation of HF)
fracture risk due to fat accumulation in bone marrow (up to double the risk)

Question 15

are TZDs used in Over 65s?

Answer 15

no, only very rarely with proper cardiac and fracture risk assessment