Международный эндокринологический журнал 5 (45) 2012
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Angiotensin converting enzyme inhibitors for prevention of new-onset type 2 diabetes mellitus: a meta-analysis of 72,128 patients
Авторы: Geng D.F., Jin D.M., Wu W. et al.
Рубрики: Эндокринология
Разделы: Справочник специалиста
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Backgroud. Angiotensin converting enzyme inhibitors (ACEIs) have been linked to reduced risk of new-onset diabetes, but the evidence was insufficient.
Objective and methods. The aim of this study was to evaluate the effect of ACEIs on the development of new-onset type 2 diabetes. Randomized controlled trials (RCTs) about ACEIs and new-onset diabetes were identified by electronic and manual searches.
Results. Nine RCTs with 92,404 patients (72,128 non-diabetic patients at baseline) were included in this study. Compared with control group, incidence of new-onset diabetes was significantly reduced in the ACEIs group (OR 0.80 (0.71, 0.91)), irrespective of achieved blood pressure levels at the follow-up. ACEIs therapy was associated with significant reduction in the risk of new-onset diabetes compared with beta-blockers/diuretics (OR 0.78 (0.65, 0.93)), placebo (OR 0.79 (0.64, 0.96)), or calcium channel blockers (OR 0.85 (0.73, 0.99)). ACEIs treatment was associated with significant reduction in the risk of new-onset diabetes in patients with hypertension (OR 0.80 (0.68, 0.93)), coronary artery disease (CAD) or cardiovascular disease (OR 0.83 (0.68, 1.00)), or heart failure (OR 0.22 (0.10, 0.47). Among patients with impaired glucose tolerance or impaired fasting glucose, ramipril did not significantly reduce the incidence of diabetes (OR 0.91 (0.79, 1.05)), but significantly increased regression to normoglycemia.
Conclusion. ACEIs have beneficial effects in preventing new-onset diabetes. ACEIs provide additional benefits of lowering the risk of new-onset diabetes in patients with hypertension, CAD or other cardiovascular disease.
International Journal of Cardiology. — July 2012