The effect of Thiazolidinediones on the vascular endothelium and plaque in diabetic patients with coronary atherosclerosis：a meta-analysis

Rosiglitazone (Avandia) and Pioglitazone (Actos) belong to the class of thiazolidinedione drugs that act by increasing insulin sensitivity and are widely used for treating diabetic patients with insulin resistance. Thiazolidinediones (TZDs) exhibit anti-inflammatory and antioxidant properties and inhibit endothelial cell inflammation and dysfunction, and then play a role in inhibiting plaque formation and coronary atherosclerosis. But the results of evidence-based medicine suggest that thiazolinedione may increase the risk of myocardial infarction. To explore the dispute in depth, the meta-analysis aimed to evaluate the changes in vascular endothelial and plaque-related indicators following treatment with thiazolidinediones on diabetic patients with coronary atherosclerosis.According to our meta-analysis, Thiazolinediones showed a protective effect on the vascular endothelium and an inhibiting effect on plaque progression in patients with diabetes and coronary atherosclerosis and these effects may not depend on related targets or pathways such as inflammation and lipid regulation. Due to the poor quality of the evidence, more and higher-quality studies are needed to further improve the above conclusions.