Since their approval, thiazolidinediones (TZDs) have been used extensively as insulin-sensitizers for the management of type 2 diabetes mellitus (T2DM). Activation of peroxisomal proliferator-activated receptor gamma (PPARγ) nuclear receptors by TZDs leads to a vast spectrum of metabolic and antiinflammatory effects. In the past decade, clinicians and scientists across the fields of metabolism, diabetes, liver disease (NAFLD), atherosclerosis, inflammation, infertility, and even cancer have had high hopes about the potential for TZDs to treat many of these diseases. However, an increasing awareness about undesirable "off-target" effects of TZDs have made us rethink their role and be more cautious about the long-term benefits and risks related to their use. This review examines the most relevant work on the benefits and risks associated with TZD treatment, with a focus on the only PPARγ agonist currently available (pioglitazone), aiming to offer the reader a balanced overview about the current and future role of TZDs in the management of insulin-resistant states and T2DM.

El plomo es uno de los metales pesados más tóxicos y la exposición humana, por razones laborales, a este metal, puede causar plumbemia. El objetivo de la investigación fue generar una línea base sobre las concentraciones de plomo en sangre de un grupo de trabajadores de fábricas de baterías en Guayaquil-Ecuador y de un grupo control no expuesto laboralmente al metal, con el fin de establecer la existencia de riesgo ocupacional entre sexos, edades y puestos de trabajo. Para ello, se procedió a tomar muestras de sangre a los trabajadores y al grupo control. Las muestras fueron analizadas por espectrofotometría de absorción atómica con horno de grafito. El 100 % de los trabajadores presentaron Pb en una concentración promedio de 16.22±6.82 µg/dL superior al valor de la Organización Mundial de la Salud, pero inferior al límite establecido por la Administración de Seguridad y Salud Ocupacional de 40 µg/dL; además, el valor fue superior al del grupo control (0.68±0.15 µg/dL). Los hombres presentaron mayores niveles de Pb que las mujeres, y estos valores variaron dependiendo del puesto de trabajo en la fábrica. En conclusión, el 100 % del grupo control y el 4.55 % de los trabajadores no presentaron riesgo de intoxicación por plomo, un 13.64 % presentó riesgo bajo, 78.79 % riesgo medio y solo un 3.00 % riesgo alto.

A 38-year-old Caucasian woman was referred to our care with a presumed diagnosis of primary hyperaldosteronism and an associated large adrenal mass. She was found by her primary care physician (PCP) to have severe hypokalemia on routine lab work although she was completely asymptomatic. Past medical history included osteoporosis, hyperlipidemia, meningioma, seizure disorder, and hypothyroidism. Family history included type 2 diabetes (T2D), hypertension, dyslipidemia, and coronary heart disease. Medications at the time of endocrine evaluation included KCl 40 mEq p.o. q.i.d., diltiazem 60 mg p.o. q.i.d., losartan 25 mg p.o. daily, spirinolactone 50 mg p.o. daily, insulin glargine 45 units subcutaneously b.i.d., insulin aspart 26 units subcutaneously before meals, and a correction scale and pioglitazone 15 mg daily. On examination, blood pressure was 177/90 mmHg and pulse was 112 bpm. She was 4′ 9″ tall, weighed 36 kg and had a BMI of 17.2 kg/m2. Physical examination revealed a young female with a round face, bilateral clavicular fullness, and proximal muscle wasting of the extremities but no acanthosis nigricans, facial plethora, acne, bruises, hirsutism, central obesity, or purple striae.