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Effect of rosiglitazone on circulating malondialdehyde (MDA) level in diabetes based on a systematic review and meta-analysis of eight clinical trials
  1. Ziba Majidi1,
  2. Shaghayegh Hosseinkhani1,
  3. Nasrin Amiri-Dashatan2,
  4. Solaleh Emamgholipour1,
  5. Sara Tutunchi3,
  6. Javad Hashemi4,
  7. Fatemeh Ghorbani1,
  8. Mehdi Koushki5
  1. 1 Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  2. 2 Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  3. 3 Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran (the Islamic Republic of)
  4. 4 Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnord, Iran (the Islamic Republic of)
  5. 5 Department of Clinical Biochemistry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran (the Islamic Republic of)
  1. Correspondence to Dr Mehdi Koushki, Zanjan, Iran (the Islamic Republic of); mehdikoushki89{at}


Patients with type 2 diabetes have high levels of malondialdehyde (MDA), and clinical data suggest a reducing effect of rosiglitazone (RSG) on the level of MDA in these patients. However, the results of available studies on the level of MDA in RSG-treated patients are not univocal. This meta-analysis aimed to assess the impact of RSG on the level of MDA. We performed a comprehensive search of PubMed, the Institute for Scientific Information Web of Science, Embase, Scopus, and Cochrane Library for related controlled trials until July 2020. Eligible studies were selected based on the inclusion criteria. Extracted data from each study were combined using a random-effects model. Sensitivity and subgroup analyses were conducted to explore potential heterogeneity. Eight trials with 456 subjects met the inclusion criteria. The results significantly showed the reducing effect of RSG on circulating MDA level (−0.47 μmol/mL; 95% CI −0.93 to −0.01; p=0.04; I2=82.1%; p heterogeneity=0.00) in individuals with T2D. No publication bias was observed with Begg’s rank correlation (p=0.71) and Egger’s linear regression (p=0.52) tests. Subgroup analyses showed that an intervention dose of 8 mg/day in serum samples was found to have a reducing effect on the level of MDA (−0.56 μmol/mL; 95% CI −0.98 to −0.14; p=0.008; I2=11.4%; p heterogeneity=0.32). Random-effects meta-regression did not show any significant association between the level of MDA and potential confounders including RSG dose, treatment duration, and sex. In conclusion, we found a significant reduction in MDA concentration in subjects with T2D who received a dose of 8 mg of RSG daily.

  • diabetes complications
  • diabetes mellitus
  • drugs
  • investigational
  • lipid metabolism

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  • Correction notice Since the Online First publication of this article, the affiliation of Javad Hashemi has been updated from 'Department of Clinical Biochemistry, Faculty of Medicine' to 'Department of Pathobiology and Laboratory Sciences, School of Medicine'.

  • Contributors ZM, SH, NA-D and MK conceptualized and designed the research. SE, ST and JH critically reviewed the manuscript and approved the final manuscript as submitted. ZM, SH, FG and MK wrote the draft of this paper. All authors directly participated in the data collection, statistical analyses and data interpretation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.