Abstract

Background: Angiotensin II has been shown to increase hepatic glucose production and decrease insulin sensitivity. Angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) which are being extensively used to control hypertension, are associated with a decreased incidence of new-onset diabetes mellitus (DM). But, there have been limited data of different impact of ACEI versus ARB on new-onset DM in Asian population.

Methods: We investigated total 1,856 patients (pts) who did not have DM from January 2004 to September 2009. To adjust potential confounders, a propensity score matched (PSM) analysis was performed using the logistic regression model. The primary end-point was the cumulative incidence of new-onset DM which was defined as having a fasting blood glucose ≥126 mg/dL or HbA1c ≥ 6.5%. Also, multivariable cox-regression analysis by aforementioned variables was performed to determine the different impact of ACEI versus ARB on new-onset DM.

Results: Mean follow-up duration was 963±293 days in all-pt group, and 970±288 days in PSM group. After PSM (C-statistics: 0.728), a total 642 baseline adjusted pts (ACEI group=321 and control group = 321) were sorted out for analysis. In Kaplan-Meyer curve following both multivariate analysis and PSM, there was no difference in the cumulative incidences of new-onset DM between ACEI and ARB groups (p=0.145, figure).

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Conclusions; In the present study, there was no difference in the cumulative incidences of new-onset DM between ACEI and ARB groups in a series of cardiovascular pts in Asian population.