Effect of thiazolidinediones (glitazones) groups on glycemic control and lipid profile: a meta-analysis of randomized control trials.

ABSTRACT

Background & objectives: In patients with type 2 diabetes mellitus, all therapeutic options should be evaluated for their effect on cardiovascular risk factors, in addition to glycemic control. Randomized controlled trials of pioglitazone and rosiglitazone in patients with type 2 diabetes to evaluate their effect on either glycemic control or serum lipid profile individually have been reviewed and analyzed but analysis of reports of effect on both these parameters simultaneously are very few and such meta-analysis has not been carried out earlier. This article presents meta-analysis of randomized controlled trials of pioglitazone and rosiglitazone in patients with type 2 diabetes to evaluate their effect on glycemic control as well as serum lipid profile. Methods: We identified the citations by searching the web site of MD-consult, National Library of Medicine and Google for identifying randomized controlled trails pertinent to the thiazolidinediones of interest (rosiglitazone and pioglitazone) and evaluated then compared effect of these two drugs on glycemic control and serum lipid profile by applying student’s t-test.Results: Twelve randomized controlled trials (n=10052) were identified. Both thiazolidinediones produced significant reduction in HbA1c and FPG. Pioglitazone significantly reduced TG and increased HDL-C levels without significant effect on LDL-C and Total CH; while rosiglitazone significantly increased HDL-C, LDL-C, Total CH and slightly increased TG. Comparatively, they did not differ in their effect on glycemic control but regarding lipid profile, pioglitazone significantly reduced TG whereas rosiglitazone slightly increased TG level. Rosiglitazone produced significantly more increase in LDL-C and total CH level as compared to pioglitazone. Interpretation & conclusion: Pioglitazone had significantly more beneficial effects on lipid profile than Rosiglitazones and is clinically superior in patient of Type-2 DM with dyslipidemia.