Targeting adipose remodeling: Synergistic mechanisms of drugs and adipose-derived stem cells in obese type 2 diabetes mellitus

Figure 1 Mechanistic illustration of pioglitazone-induced adipose tissue remodeling via peroxisome proliferator-activated receptor gamma activation. This schematic illustrates the core mechanisms by which pioglitazone exerts its insulin-sensitizing effects. Peroxisome proliferator-activated receptor gamma, a key transcription factor that promotes the differentiation of preadipocytes into mature adipocytes, particularly in subcutaneous fat depots. This expansion of subcutaneous fat enhances lipid storage capacity, facilitating the redistribution of lipids away from visceral and ectopic sites (e.g., liver, muscle). The resulting reduction in lipotoxicity and inflammation improves insulin sensitivity and metabolic homeostasis. Additionally, peroxisome proliferator-activated receptor gamma activation upregulates adiponectin and suppresses proinflammatory pathways, contributing to the anti-inflammatory effects of pioglitazone. PPARγ: Peroxisome proliferator-activated receptor gamma.