title: Impact of Angiotensin Converting Enzyme Inhibitor versus Angiotensin Receptor Blocker on Incidence of New-Onset Diabetes Mellitus in Asians.
abstract: OBJECTIVE
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. swrha617@yahoo.co.kr.
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Byoung Geol
authors.initials: BG
authors.lastname: Choi
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Se Yeon
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Department of Cardiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
authors.forename: Jae Woong
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Cardiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
authors.forename: Sung Kee
authors.initials: SK
authors.lastname: Ryu
authors.affiliation: Department of Cardiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
authors.forename: Seunghwan
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Computer Science, Korea Advanced Institute of Science and Technology, Daejeon, Korea.
authors.forename: Yung Kyun
authors.initials: YK
authors.lastname: Noh
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Raghavender Goud
authors.initials: RG
authors.lastname: Akkala
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hu
authors.initials: H
authors.lastname: Li
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jabar
authors.initials: J
authors.lastname: Ali
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ji Bak
authors.initials: JB
authors.lastname: Kim
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sunki
authors.initials: S
authors.lastname: Lee
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Na
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hong Euy
authors.initials: HE
authors.lastname: Lim
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D044466:Asian People / Q000706:statistics & numerical data*; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D057216:Propensity Score; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose
keywords: Angiotensin converting enzyme inhibitor; angiotensin receptor blocker; diabetes mellitus