Strategies for the development of new PPAR agonists in diabetes.

Diabetes is associated with a range of metabolic abnormalities including insulin resistance, atherogenic dyslipidemia, hypertension, and inflammation. These factors are likely to underlie the adverse cardiovascular outcome typically observed in diabetic cohorts. The family of peroxisome proliferator-activated receptors (PPARs) have been implicated in the regulation of a number of physiologic and metabolic pathways. Pharmacologic agonists directed against various PPARs have been shown to have a beneficial impact on these metabolic risk factors. The potential impact on cardiovascular risk with the use of PPAR agonists will be reviewed.