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Thiazolidinediones improve flow-mediated dilation: a meta-analysis of randomized clinical trials

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Abstract

Aims

Thiazolidinediones administration is assumed to be related with an improvement of endothelial dysfunction (ED); nevertheless, previous studies have been inconsistent. For this reason, the present meta-analysis was directed to estimate if thiazolidinediones were related to endothelial dysfunction improvement by using flow-mediated dilation (FMD) measurement.

Methods

Literature search of the PubMed, the Cochrane Library, the Web of Science, and the Scopus databases was performed covering the period until July 01, 2015, for randomized clinical trials that investigated an influence of thiazolidinediones on FMD. For the calculation of the pooled overall effect, a random effect model was used. Meta-regression and subgroup analyses were performed to evaluate the impact of study characteristics on the effect of thiazolidinediones administration on FMD.

Results

This meta-analysis included 16 studies with 812 subjects. The obtained results demonstrated an improvement of endothelial dysfunction measured with FMD (16 studies, 812 subjects; WMD: 2.4 %, 95 % CI = 1.1 to 3.69 %; p = 0.0003). The significant heterogeneity was noted (I 2 = 95 %, p < 0.00001). Subgroup analysis demonstrated that pioglitazone and rosiglitazone were able to improve FMD. Also, thiazolidinediones improved FMD if treatment was longer than 12 weeks and if patients were younger than 65 years. Additionally, a lipid profile was found to influence thiazolidinediones effect on FMD.

Conclusion

The results of this meta-analysis demonstrated that thiazolidinediones were able to improve FMD, which in clinical terms can be further translated to the improvement of an impaired endothelial function. Nevertheless, the link between FMD and its predictive clinical relevance still requires further clarification.

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Acknowledgments

The present meta-analysis was supported by the Ministry of Education, Science and Technological Development—Republic of Serbia with Grant 175023. Only the authors were responsible for the study design, the collection of data and analysis of data, publishing decision, and preparation of the manuscript.

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Authors and Affiliations

  1. Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, PO Box 38, Belgrade, 11129, Serbia

    Marko Stojanović, Milica Prostran & Miroslav Radenković

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  1. Marko Stojanović
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  2. Milica Prostran
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  3. Miroslav Radenković
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Correspondence to Miroslav Radenković.

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The authors declare that they have no competing interests.

Author contributions

The authors’ responsibilities were as follows: M.S. designed the study and conducted the literature review, performed the statistical analyses, interpreted the data, and wrote the manuscript; M.P. provided critical assessment of the final version of the manuscript; M.R. designed the study, wrote the manuscript, made critical assessment of the final version of the manuscript, and had overall responsibility for the study. All authors read and approved the final manuscript.

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Stojanović, M., Prostran, M. & Radenković, M. Thiazolidinediones improve flow-mediated dilation: a meta-analysis of randomized clinical trials. Eur J Clin Pharmacol 72, 385–398 (2016). https://doi.org/10.1007/s00228-015-1999-4

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  • DOI: https://doi.org/10.1007/s00228-015-1999-4

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