Impact of angiotensin converting enzyme inhibitor versus angiotensin receptor blocker on incidence of new-onset diabetes mellitus in Asians

Ji Young Park, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Woong Choi, Sung Kee Ryu, Se Jin Lee, Seunghwan Kim, Yung Kyun Noh, Raghavender Goud Akkala, Hu Li, Jabar Ali, Ji Bak Kim, Sunki Lee, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu ParkHong Seog Seo, Dong Joo Oh

Research output: Contribution to journalArticle

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Abstract

Purpose: Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) are associated with a decreased incidence of new-onset diabetes mellitus (NODM). The aim of this study was to compare the protective effect of ACEI versus ARBs on NODM in an Asian population. Materials and Methods: We investigated a total of 2817 patients who did not have diabetes mellitus from January 2004 to September 2009. To adjust for potential confounders, a propensity score matched (PSM) analysis was performed using a logistic regression model. The primary end-point was the cumulative incidence of NODM, which was defined as having a fasting blood glucose ≥126 mg/dL or HbA1c ≥6.5%. Multivariable cox-regression analysis was performed to determine the impact of ACEI versus ARB on the incidence of NODM. Results: Mean follow-up duration was 1839±1019 days in all groups before baseline adjustment and 1864±1034 days in the PSM group. After PSM (C-statistics=0.731), a total 1024 patients (ACEI group, n=512 and ARB group, n=512) were enrolled for analysis and baseline characteristics were well balanced. After PSM, the cumulative incidence of NODM at 3 years was lower in the ACEI group than the ARB group (2.1% vs. 5.0%, p=0.012). In multivariate analysis, ACEI vs. ARB was an independent predictor of the lower incidence for NODM (odd ratio 0.37, confidence interval 0.17–0.79, p=0.010). Conclusion: In the present study, compared with ARB, chronic ACEI administration appeared to be associated with a lower incidence of NODM in a series of Asian cardiovascular patients.

Original languageEnglish
Pages (from-to)180-186
Number of pages7
JournalYonsei Medical Journal
Volume57
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

Fingerprint

Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Diabetes Mellitus
Propensity Score
Incidence
Logistic Models
Social Adjustment
Blood Glucose
Fasting
Research Design
Multivariate Analysis
Odds Ratio
Regression Analysis
Confidence Intervals
Population

Keywords

  • Angiotensin converting enzyme inhibitor
  • Angiotensin receptor blocker
  • Diabetes mellitus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Impact of angiotensin converting enzyme inhibitor versus angiotensin receptor blocker on incidence of new-onset diabetes mellitus in Asians. / Park, Ji Young; Rha, Seung-Woon; Choi, Byoung Geol; Choi, Se Yeon; Choi, Jae Woong; Ryu, Sung Kee; Lee, Se Jin; Kim, Seunghwan; Noh, Yung Kyun; Akkala, Raghavender Goud; Li, Hu; Ali, Jabar; Kim, Ji Bak; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Jin Won; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo.

In: Yonsei Medical Journal, Vol. 57, No. 1, 01.01.2016, p. 180-186.

Research output: Contribution to journalArticle

Park, Ji Young ; Rha, Seung-Woon ; Choi, Byoung Geol ; Choi, Se Yeon ; Choi, Jae Woong ; Ryu, Sung Kee ; Lee, Se Jin ; Kim, Seunghwan ; Noh, Yung Kyun ; Akkala, Raghavender Goud ; Li, Hu ; Ali, Jabar ; Kim, Ji Bak ; Lee, Sunki ; Na, Jin Oh ; Choi, Cheol Ung ; Lim, Hong Euy ; Kim, Jin Won ; Kim, Eung Ju ; Park, Chang Gyu ; Seo, Hong Seog ; Oh, Dong Joo. / Impact of angiotensin converting enzyme inhibitor versus angiotensin receptor blocker on incidence of new-onset diabetes mellitus in Asians. In: Yonsei Medical Journal. 2016 ; Vol. 57, No. 1. pp. 180-186.
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AU - Choi, Se Yeon

AU - Choi, Jae Woong

AU - Ryu, Sung Kee

AU - Lee, Se Jin

AU - Kim, Seunghwan

AU - Noh, Yung Kyun

AU - Akkala, Raghavender Goud

AU - Li, Hu

AU - Ali, Jabar

AU - Kim, Ji Bak

AU - Lee, Sunki

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Lim, Hong Euy

AU - Kim, Jin Won

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AU - Seo, Hong Seog

AU - Oh, Dong Joo

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N2 - Purpose: Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) are associated with a decreased incidence of new-onset diabetes mellitus (NODM). The aim of this study was to compare the protective effect of ACEI versus ARBs on NODM in an Asian population. Materials and Methods: We investigated a total of 2817 patients who did not have diabetes mellitus from January 2004 to September 2009. To adjust for potential confounders, a propensity score matched (PSM) analysis was performed using a logistic regression model. The primary end-point was the cumulative incidence of NODM, which was defined as having a fasting blood glucose ≥126 mg/dL or HbA1c ≥6.5%. Multivariable cox-regression analysis was performed to determine the impact of ACEI versus ARB on the incidence of NODM. Results: Mean follow-up duration was 1839±1019 days in all groups before baseline adjustment and 1864±1034 days in the PSM group. After PSM (C-statistics=0.731), a total 1024 patients (ACEI group, n=512 and ARB group, n=512) were enrolled for analysis and baseline characteristics were well balanced. After PSM, the cumulative incidence of NODM at 3 years was lower in the ACEI group than the ARB group (2.1% vs. 5.0%, p=0.012). In multivariate analysis, ACEI vs. ARB was an independent predictor of the lower incidence for NODM (odd ratio 0.37, confidence interval 0.17–0.79, p=0.010). Conclusion: In the present study, compared with ARB, chronic ACEI administration appeared to be associated with a lower incidence of NODM in a series of Asian cardiovascular patients.

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