This hypothesis is also supported by an in vitro study in cardiomyocytes by Sandra and colleagues [45] which demonstrated that cardiac hypertrophy associated with the treatment of PPAR-γ agonists was not due to the direct cardiac effects of PPAR agonists, for example, activation of cardiac PPAR-γ receptors or increased myocardial insulin sensitivity. This evidence concerns the gene PPARA and cardiac hypertrophy.