title: 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)-α/δ agonist, on peripheral and hepatic insulin sensitivity.
  
  
  METHODS
  Twenty-two abdominally obese insulin-resistant males (homeostasis model assessment of insulin resistance>3) were randomly assigned in a randomized crossover study to subsequent 8-week treatment periods with GFT505 (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.
  
  
  RESULTS
  GFT505 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=0.006) 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±0.07 vs. 0.27±0.11 mmol/L; P=0.006). Neither PPARα nor PPARδ target genes were induced in skeletal muscle, suggesting a liver-targeted action of GFT505. GFT505 significantly reduced fasting plasma triglycerides (-21%; P=0.003) and LDL cholesterol (-13%; P=0.0006), as well as liver enzyme concentrations (γ-glutamyltranspeptidase: -30.4%, P=0.003; alanine aminotransferase: -20.5%, P=0.004). There was no safety concern or any indication of PPARγ activation with GFT505.
  
  
  CONCLUSIONS
  The dual PPARα/δ 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.
authors.affiliation: Corresponding author: Bertrand Cariou, bertrand.cariou@univ-nantes.fr.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Cariou
authors.forename: Rémy
authors.initials: R
authors.lastname: Hanf
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Lambert-Porcheron
authors.forename: Yassine
authors.initials: Y
authors.lastname: Zaïr
authors.forename: Valérie
authors.initials: V
authors.lastname: Sauvinet
authors.forename: Benoit
authors.initials: B
authors.lastname: Noël
authors.forename: Laurent
authors.initials: L
authors.lastname: Flet
authors.forename: Hubert
authors.initials: H
authors.lastname: Vidal
authors.forename: Bart
authors.initials: B
authors.lastname: Staels
authors.forename: Martine
authors.initials: M
authors.lastname: Laville
mesh_terms: D000328:Adult; D047188:Chalcones / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008074:Lipoproteins / Q000097:blood; D008099:Liver / Q000187:drug effects* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000378:metabolism; D009765:Obesity / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D047493:PPAR alpha / Q000819:agonists*; D047494:PPAR delta / Q000819:agonists*; D011422:Propionates / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: C585906:2-(2,6-dimethyl-4-(3-(4-(methylthio)phenyl)-3-oxo-1-propenyl)phenoxyl)-2-methylpropanoic acid; D047188:Chalcones; D008074:Lipoproteins; D047493:PPAR alpha; D047494:PPAR delta; D011422:Propionates