A drug that acts as a PPAR-gamma (peroxisome proliferator-activated receptor gamma) agonist would mimic which class of antidiabetic agents, and through which mechanism?

• A Thiazolidinediones — enhancing insulin sensitivity by inducing adipokine gene expression ✓
• B Sulfonylureas — closing ATP-sensitive K+ channels
• C DPP-4 inhibitors — increasing GLP-1 half-life
• D Biguanides — activating AMPK in hepatocytes

Explanation

PPAR-gamma is a nuclear receptor/transcription factor predominantly expressed in adipose tissue. Its activation by thiazolidinediones (TZDs, e.g., pioglitazone) results in transcriptional changes that reduce adipocyte size, increase expression of adiponectin (an insulin-sensitizing adipokine), redistribute fat from visceral to subcutaneous depots, and improve insulin signaling in muscle and liver. This is a genomic (nuclear receptor) mechanism of action, distinct from the rapid non-genomic signaling of membrane receptors. Options A, C, and D describe other classes with different targets.

Reference: Harper's Illustrated Biochemistry, 32nd ed.

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