Oxidative stress is increased, while serum PON1 activity is decreased in BTT subjects. Decrease in PON1 activity is associated with the degree of oxidative stress, anaemia and increase in CIMT. Therefore, BTT subjects may be more prone to development of atherosclerosis.

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Background Pioglitazone’s role in the induction of atheroma regression in diabetics was suggested by several RCT. The aim of our study was to evaluate this role through a systematic review of all RCT conducted on this subject. Methods Literature was searched for relevant studies. We included all RCT that compared pioglitazone versus other antidiabetic agents. Mean differences of either AV or CIMT, HbA1C, HDL, and LDL between the two groups were used to assess the effect of pioglitazone versus alternative therapies. Results Six RCT were included with a total of 1180 patients. Pioglitazone was significantly superior to glimepiride and gliclazide in improving IMT. No significant difference was observed in overall AV, HbA1C, and LDL. Conclusion The latter findings confirm that anti-atheroma action of pioglitazone is not achieved through its antiglycemic or antidyslipidemia effects, but probably through a DNA-mediated effect, and may lead to its repurposing for reversal of organ fibrosis.

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