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Although Pioglitazone was initially thought to act only as a direct transcriptional regulation of the PPAR nuclear receptor, later data revealed that it also binds to mitochondrial membranes ( Studies conducted in multiple cell types demonstrated that TZDs inhibit mitochondrial pyruvate carrier (MPC) activity by direct binding (McCommis and Finck, 2015)

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While these fields were once studied in isolation, we now understand them as a singular, integrated system where mitochondrial health dictates the efficiency of fat oxidation