Targeting BCAA/PPAR-γ Axis with Pioglitazone Reverses Insulin Resistance and Mitigates Post-Cardiac Arrest…

Case-controlResuscitation· Aug 2026

Targeting BCAA/PPAR-γ Axis with Pioglitazone Reverses Insulin Resistance and Mitigates Post-Cardiac Arrest Injury.

Wentao Sang, Xiyu Pan, Fengyang Xu … Feng Xu

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Resuscitation & Cardiac ArrestCase-controlQ1IF 3.5

Pioglitazone raised post-cardiac-arrest survival by 40% in rats via insulin resistance reversal

Targeting BCAA/PPAR-γ Axis with Pioglitazone Reverses Insulin Resistance and Mitigates Post-Cardiac Arrest Injury.

Wentao Sang … Feng Xu

Resuscitation · Aug 2026 · Q1 in Emergency Medicine

Background

Metabolic dysfunction contributes to poor outcomes after cardiac arrest (cardiac arrest).

Purpose

We aimed to explore whether insulin resistance (insulin resistance) induced by dysregulated branched-chain amino acid (branched-chain amino acid) metabolism is the core driver of post-cardiac arrest brain injury, and to verify the therapeutic potential of pioglitazone targeting this pathway.

Methods

A retrospective cohort (121 cardiac arrest patients) and a prospective case-control study (25 cardiac arrest patients vs.

n = 21 controls

40%

Results

40%

pioglitazone raised survival after cardiac arrest versus untreated rats

n = 21 controls

More results

In cardiac arrest rat model, systemic and cerebral insulin resistance developed by 72 hours post-resuscitation.

“

Conclusion · 1 of 2

Dysregulated branched-chain amino acid metabolism triggers insulin resistance via PPAR-γ suppression after cardiac arrest, exacerbating ischemic brain injury.

Conclusion · 2 of 2

Targeting the branched-chain amino acid/PPAR-γ/insulin resistance axis with pioglitazone effectively reverses this pathology, providing a mechanistically grounded and highly translatable therapeutic strategy for post-resuscitation care.

Targeting BCAA/PPAR-γ Axis with Pioglitazone Reverses Insulin Resistance and Mitigates Post-Cardiac Arrest Injury.

Targeting BCAA/PPAR-γ Axis with Pioglitazone Reverses Insulin Resistance and Mitigates Post-Cardiac Arrest Injury.

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