Table 1.
Current and emerging pharmacological treatments for the metabolic syndrome
| Drug Famil: | Name, Functions and Applications: |
|---|---|
| Statins | a. Atorvastatin |
| -Lowers LDL-C levels | |
| -Ameliorates hepatic lipoprotein overproduction | |
| -Enhances hepatic insulin sensitivity and signaling | |
| b. Simvastatin | |
| -Lowers LDL-C levels | |
| -Increases plasma concentrations of HDL-C through elevating plasma concentration of apoA1 in patients with hyperlipidemia | |
| c. Rosuvastatin | |
| -Has the highest efficacy in reducing LDL-C, apoB, and non HDL-C than other statins at comparable doses | |
| Cholesterol Absorption Inhibitors | a. Ezetimibe |
| -Inhibits the intestinal absorption of dietary and biliary cholesterol | |
| -Reduces the LDL-C levels by 20–25% when administered as either monotherapy or in combination with a statin | |
| -Reduces C-reactive protein levels | |
| Insulin sensitizing agents | a. Rosiglitazone |
| -Ameliorates whole body insulin resistance | |
| -Improves hepatic insulin signaling | |
| -Reduces hepatic lipoprotein over production | |
| b. Metformin | |
| -Reduces excessive rates of hepatic glucose production | |
| -Improves insulin-stimulated glucose utilization by extra hepatic tissues | |
| -Lowers circulating levels of plasminogen activator inhibitor-1, hence lowering atherothrombotic events | |
| -Reduces progression to diabetes among overweight and obese glucose-intolerant individuals | |
| -Decreases weight gain in part by reducing dietary energy intake | |
| -A useful adjunct in insulin-requiring patients with type 2 diabetes | |
| GLP-1 Receptor Agonists | a. Exenatide |
| -Stimulates replication and inhibits apoptosis of islet beta cells | |
| -Sustains reductions in HbA1c levels with progressive loss of body weight | |
| -Improves glycemic control as a result of progressive reductions in body weight | |
| -Improves blood pressure, lipid profiles and hepatic transaminase levels | |
| -Reduces the infiltration of fat into liver | |
| DPP-4 Inhibitors | a. Sitagliptin |
| -Used either alone or in combination with other oral antihyperglycemic agents (such as metformin or a thiazolidinedione) for treatment of diabetes mellitus type 2 | |
| -Improves glycaemic control in adults with type 2 diabetes | |
| -Not licensed for use in combination with insulin therapy | |
| -Significantly reduces HbA1c and fasting plasma glucose levels | |
| -Ameliorates insulin secretion through improving the proinsulin to insulin ratio | |