Dual peroxisome proliferator- activated receptor α/δ agonist gft505 improves hepatic and peripheral insulin sensitivity in abdominally obese subjects

Abstract

OBJECTIVE The development of new insulin sensitizers is an unmet need for the treatment of type 2 diabetes. We investigated the effect of GFT505, a dual peroxisome proliferator- activated receptor (PPAR)-a/d agonist, on peripheral and hepatic insulin sensitivity. RESEARCH DESIGN AND METHODSdTwenty-two abdominally obese insulinresistant males (homeostasis model assessment of insulin resistance .3) were randomly assigned in a randomized crossover study to subsequent 8-week treatment periodswithGFT505 (80 mg/day) or placebo, followed by a two-step hyperinsulinemic-euglycemic insulin clamp with a glucose tracer to calculate endogenous glucose production (EGP). The primary end point was the improvement in glucose infusion rate (GIR). Gene expression analysis was performed on skeletal muscle biopsy specimens. RESULTSdGFT505 improved peripheral insulin sensitivity, with a 21% (P = 0.048) increase of the GIR at the second insulin infusion period. GFT505 also enhanced hepatic insulin sensitivity, with a 44% (P = .006) increase of insulin suppression of EGP at the first insulin infusion period. Insulin-suppressed plasma free fatty acid concentrations were significantly reduced on GFT505 treatment (0.21±07 vs. 0.27±0.11mmol/L; P = 0.006). Neither PPARa nor PPARd target genes were induced in skeletal muscle, suggesting a liver-targeted action of GFT505. GFT505 significantly reduced fasting plasma triglycerides (221%; P = 0.003) and LDL cholesterol (213%; P = 0.0006), as well as liver enzyme concentrations (g-glutamyltranspeptidase: 230.4%, P = 0.003; alanine aminotransferase:220.5%, P = 0.004). There was no safety concern or any indication of PPARg activation with GFT505. CONCLUSIONSdThe dual PPARa/d agonist GFT505 is a liver-targeted insulin-sensitizer that is a promising drug candidate for the treatment of type 2 diabetes and nonalcoholic fatty liver disease. © 2013 by the American Diabetes Association.