title: A selective peroxisome proliferator-activated receptor alpha agonist, CP-900691, improves plasma lipids, lipoproteins, and glycemic control in diabetic monkeys.
abstract: Peroxisome proliferator-activated receptors (PPARs) are involved in the regulation of lipid and glucose metabolism. PPARgamma agonists improve insulin sensitivity and hyperglycemia and are effective in treating type 2 diabetes mellitus (T2DM), whereas PPARalpha agonists are used to treat dyslipidemia and atherosclerosis. The goal here was to examine the efficacy of a selective PPARalpha agonist {(S)-3-[3-(1-carboxy-1-methyl-ethoxy)-phenyl]-piperidine-1-carboxylic acid 4-trifluoromethyl-benzyl ester; CP-900691} on lipid, glycemic, and inflammation indices in 14 cynomolgus monkeys with spontaneous T2DM maintained on daily insulin therapy. Monkeys were dosed orally with either vehicle (n = 7) or CP-900691 (3 mg/kg, n = 7) daily for 6 weeks. CP-900691 treatment increased plasma high-density lipoprotein cholesterol (HDLC) (33 +/- 3 to 60 +/- 4 mg/dL, p < 0.001) and apolipoprotein A1 (96 +/- 5 to 157 +/- 5 mg/dL, p < 0.001), reduced plasma triglycerides (547 +/- 102 to 356 +/- 90 mg/dL, p < 0.01), and apolipoprotein B (62 +/- 3 to 45 +/- 3 mg/dL, p < 0.01), improved the lipoprotein index (HDL to non-HDLC ratio; 0.28 +/- 0.06 to 0.79 +/- 0.16, p < 0.001), decreased body weight (p < 0.01) and C-reactive protein (CRP) (1700 +/- 382 to 304 +/- 102 ng/ml, p < 0.01), and increased adiponectin (1697 +/- 542 to 4242 +/- 1070 ng/ml, p < 0.001) compared with baseline. CP-900691 treatment reduced exogenous insulin requirements by approximately 25% (p < 0.04) while lowering plasma fructosamine from 2.87 +/- 0.09 to 2.22 +/- 0.17 mM (p < 0.05), indicative of improved glycemic control. There were no changes in any of the aforementioned parameters in the vehicle group. Because low HDLC and high triglycerides are well established risk factors for cardiovascular disease, the marked improvements in these parameters, and in glycemic control, body weight, and CRP, suggest that CP-900691 may be of benefit in diabetic and obese or hyperlipidemic populations.
authors.affiliation: Department of Pathology, Wake Forest University, Winston-Salem, North Carolina 27157, USA. jwagner@wfubmc.edu
authors.forename: Janice D
authors.initials: JD
authors.lastname: Wagner
authors.forename: Melanie K
authors.initials: MK
authors.lastname: Shadoan
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Gina M
authors.initials: GM
authors.lastname: Ward
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Royer
authors.forename: Kylie
authors.initials: K
authors.lastname: Kavanagh
authors.forename: Omar L
authors.initials: OL
authors.lastname: Francone
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Auerbach
authors.forename: H James
authors.initials: HJ
authors.lastname: Harwood
mesh_terms: D052242:Adiponectin / Q000097:blood; D000818:Animals; D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000235:genetics; D004305:Dose-Response Relationship, Drug; D005951:Glucose Tolerance Test; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D000960:Hypolipidemic Agents; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008252:Macaca fascicularis; D047493:PPAR alpha / Q000819:agonists*; D010880:Piperidines / Q000494:pharmacology*; D011422:Propionates / Q000494:pharmacology*; D015431:Weight Loss / Q000187:drug effects
chemical_list: C549915:3-(3-(1-carboxy-1-methylethoxy)phenyl)piperidine-1-carboxylic acid 4-trifluoromethylbenzyl ester; D052242:Adiponectin; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids; D008074:Lipoproteins; D047493:PPAR alpha; D010880:Piperidines; D011422:Propionates; D002097:C-Reactive Protein