Review Question - QID 214981

A 48-year-old man presents to the primary care clinic for an annual check-up. He has no complaints other than urinating more often over the past 3 months. His past medical history includes type 2 diabetes, hypertension, hyperlipidemia, coronary artery disease, and congestive heart failure. His medications include metformin, atorvastatin, metoprolol, lisinopril, spironolactone, and aspirin. The patient’s temperature is 98.2°F (36.8°C), blood pressure is 128/78 mmHg, pulse is 68/min, and respirations are 16/min. Cardiac exam reveals a laterally displaced point of maximal impulse and an S3 heart sound. The rest of the exam is unremarkable. A recent echocardiogram showed a left ventricular ejection fraction (LVEF) of 40%. His laboratory results are as follows:

Serum:
Na+: 142 mEq/L
Cl-: 102 mEq/L
K+: 5.0 mEq/L
HCO3-: 26 mEq/L
BUN: 28 mg/dL
Glucose: 162 mg/dL
Creatinine: 1.5 mg/dL
Hemoglobin A1c (HbA1c): 8.2%

The patient is prescribed a glycemic agent that activates a nuclear receptor to stimulate adipogenesis. Which of the following side effects is most associated with this medication?