Data_Sheet_1_Thiazolidinediones play a positive role in the vascular endothelium and inhibit plaque progression in diabetic patients with coronary atherosclerosis: A systematic review and meta-analysis.docx

Rosiglitazone (Avandia) and pioglitazone (Actos) belong to the class of thiazolidinediones (TZDs) drugs that act by increasing insulin sensitivity and are widely used for treating diabetic patients with insulin resistance. TZDs exhibit anti-inflammatory and antioxidant properties, then may play an active role in inhibiting plaque formation and coronary atherosclerosis. But the results of evidence-based medicine suggest that TZDs may increase the risk of cardiovascular adverse events. To explore the dispute in depth, our meta-analysis aimed to evaluate the changes in vascular endothelial and plaque-related indicators following treatment with TZDs in diabetic patients with coronary atherosclerosis. According to our meta-analysis, TZDs showed an inhibiting effect on plaque progression and a protective effect on the vascular endothelium in patients with diabetes and coronary atherosclerosis. Interestingly, these effects may not depend on the regulation of inflammation and lipid metabolism. By this token, TZDs may develop a potential protective effect on myocardial infarction.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42021231663].

罗格列酮（安瓦迪亚）和吡格列酮（阿卡波糖）均属于噻唑烷二酮类（TZDs）药物，其作用机制在于提升胰岛素敏感性，并广泛用于治疗患有胰岛素抵抗的糖尿病患者。噻唑烷二酮类药物具有抗炎和抗氧化特性，进而可能在抑制斑块形成和冠状动脉粥样硬化中发挥积极作用。然而，基于证据医学的研究结果显示，噻唑烷二酮类药物可能增加心血管不良事件的风险。为深入探讨此争议，本研究进行了一项荟萃分析，旨在评估接受噻唑烷二酮类药物治疗的冠状动脉粥样硬化糖尿病患者血管内皮和斑块相关指标的变化。根据我们的荟萃分析结果，噻唑烷二酮类药物在糖尿病患者和冠状动脉粥样硬化患者中显示出对斑块进展的抑制作用以及对血管内皮的保护作用。令人感兴趣的是，这些效应可能并非依赖于炎症和脂质代谢的调节。据此，噻唑烷二酮类药物可能具有对心肌梗死潜在的保护作用。系统评价注册[https://www.crd.york.ac.uk/prospero/]，注册号[CRD42021231663]。