Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study
Identifieur interne : 004A17 ( Main/Merge ); précédent : 004A16; suivant : 004A18Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study
Auteurs : Lan Shen [États-Unis, République populaire de Chine] ; Bimal R. Shah [États-Unis] ; Eric M. Reyes [États-Unis] ; Laine Thomas [États-Unis] ; Daniel Wojdyla [États-Unis] ; Peter Diem [Suisse, États-Unis] ; Lawrence A. Leiter [Canada, États-Unis] ; Bernard Charbonnel [France, États-Unis] ; Viacheslav Mareev [Russie, États-Unis] ; Edward S. Horton [États-Unis] ; Steven M. Haffner [Royaume-Uni, États-Unis] ; Vladimir Soska [République tchèque, États-Unis] ; Rury Holman [Royaume-Uni, États-Unis] ; M Angelyn Bethel [Royaume-Uni, États-Unis] ; Frank Schaper [Allemagne, États-Unis] ; Jie-Lena Sun [États-Unis] ; John Jv Mcmurray [Royaume-Uni, États-Unis] ; Robert M. Califf [États-Unis] ; Henry Krum [Australie, États-Unis]Source :
- BMJ : British Medical Journal [ 0959-8138 ] ; 2013-12-09.
Descripteurs français
- Wicri :
- topic : Collecte de données, Diabète, Glucose.
English descriptors
- KwdEn :
- Antihypertensive, Baseline, Baseline characteristics, Baseline variables, Blocker, Calcium channel blocker, Calcium channel blockers, Cardiovascular, Cardiovascular events, Cardiovascular morbidity, Cardiovascular outcomes, Confidence interval, Confounders, Covariate, Data analysis, Data collection, Data interpretation, December, Diabetes, Diabetes mellitus, Diuretic, Endpoint, Extreme weights, Fasting, Glucose, Glucose tolerance, Glucose tolerance outcomes research, Hazard ratio, Heart attack trial, High risk, High risk patients, High risk population, Hypertension, Inverse probability, Lancet, Manuscript review, Mellitus, Model hazard ratio, Navigator, Navigator trial, Novartis, Onset diabetes, Oral glucose tolerance test, Other studies, Previous studies, Randomised, Randomised trial, Reprint, Research institute, Research support, Risk factors, Serial glucose measurements, Statin, Statin therapy, Study design, Treatment initiation, Treatment patients, Treatment weighting.
- Teeft :
- Antihypertensive, Baseline, Baseline characteristics, Baseline variables, Blocker, Calcium channel blocker, Calcium channel blockers, Cardiovascular, Cardiovascular events, Cardiovascular morbidity, Cardiovascular outcomes, Confidence interval, Confounders, Covariate, Data analysis, Data collection, Data interpretation, December, Diabetes, Diabetes mellitus, Diuretic, Endpoint, Extreme weights, Fasting, Glucose, Glucose tolerance, Glucose tolerance outcomes research, Hazard ratio, Heart attack trial, High risk, High risk patients, High risk population, Hypertension, Inverse probability, Lancet, Manuscript review, Mellitus, Model hazard ratio, Navigator, Navigator trial, Novartis, Onset diabetes, Oral glucose tolerance test, Other studies, Previous studies, Randomised, Randomised trial, Reprint, Research institute, Research support, Risk factors, Serial glucose measurements, Statin, Statin therapy, Study design, Treatment initiation, Treatment patients, Treatment weighting.
Abstract
Objective To examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes. Design Reanalysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. Setting NAVIGATOR trial. Participants Patients who at baseline (enrolment) were treatment naïve to β blockers (n=5640), diuretics (n=6346), statins (n=6146), and calcium channel blockers (n=6294). Use of calcium channel blocker was used as a metabolically neutral control. Main outcome measures Development of new onset diabetes diagnosed by standard plasma glucose level in all participants and confirmed with glucose tolerance testing within 12 weeks after the increased glucose value was recorded. The relation between each treatment and new onset diabetes was evaluated using marginal structural models for causal inference, to account for time dependent confounding in treatment assignment. Results During the median five years of follow-up, β blockers were started in 915 (16.2%) patients, diuretics in 1316 (20.7%), statins in 1353 (22.0%), and calcium channel blockers in 1171 (18.6%). After adjusting for baseline characteristics and time varying confounders, diuretics and statins were both associated with an increased risk of new onset diabetes (hazard ratio 1.23, 95% confidence interval 1.06 to 1.44, and 1.32, 1.14 to 1.48, respectively), whereas β blockers and calcium channel blockers were not associated with new onset diabetes (1.10, 0.92 to 1.31, and 0.95, 0.79 to 1.13, respectively). Conclusions Among people with impaired glucose tolerance and other cardiovascular risk factors and with serial glucose measurements, diuretics and statins were associated with an increased risk of new onset diabetes, whereas the effect of β blockers was non-significant. Trial registration ClinicalTrials.gov NCT00097786.
Url:
- https://api.istex.fr/document/3FBB3288FDB8558B560FAFE3A176244F8342DB67/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898638
DOI: 10.1136/bmj.f6745
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Horton</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Joslin Diabetes Center, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Haffner, Steven M" sort="Haffner, Steven M" uniqKey="Haffner S" first="Steven M" last="Haffner">Steven M. Haffner</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Soska, Vladimir" sort="Soska, Vladimir" uniqKey="Soska V" first="Vladimir" last="Soska">Vladimir Soska</name><affiliation wicri:level="3"><country xml:lang="fr">République tchèque</country><wicri:regionArea>2nd Clinic of Internal Medicine and Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno</wicri:regionArea><placeName><settlement type="city">Brno</settlement><region>Moravie</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Holman, Rury" sort="Holman, Rury" uniqKey="Holman R" first="Rury" last="Holman">Rury Holman</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Bethel, M Angelyn" sort="Bethel, M Angelyn" uniqKey="Bethel M" first="M Angelyn" last="Bethel">M Angelyn Bethel</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Schaper, Frank" sort="Schaper, Frank" uniqKey="Schaper F" first="Frank" last="Schaper">Frank Schaper</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Center for Clinical Studies, Metabolism and Endocrinology Knowledge and Technology Transfer of Dresden University of Technology, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Sun, Jie Lena" sort="Sun, Jie Lena" uniqKey="Sun J" first="Jie-Lena" last="Sun">Jie-Lena Sun</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Mcmurray, John Jv" sort="Mcmurray, John Jv" uniqKey="Mcmurray J" first="John Jv" last="Mcmurray">John Jv Mcmurray</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>British Heart Foundation Cardiovascular Research Centre, University of Glasgow</wicri:regionArea><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName><orgName type="university">Université de Glasgow</orgName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Califf, Robert M" sort="Califf, Robert M" uniqKey="Califf R" first="Robert M" last="Califf">Robert M. Califf</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>Monash Centre of Cardiovascular Research and Education in Therapeutics, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne VIC 3004</wicri:regionArea><wicri:noRegion>Melbourne VIC 3004</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ : British Medical Journal</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1756-1833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2013-12-09">2013-12-09</date><biblScope unit="volume">347</biblScope></imprint><idno type="ISSN">0959-8138</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antihypertensive</term><term>Baseline</term><term>Baseline characteristics</term><term>Baseline variables</term><term>Blocker</term><term>Calcium channel blocker</term><term>Calcium channel blockers</term><term>Cardiovascular</term><term>Cardiovascular events</term><term>Cardiovascular morbidity</term><term>Cardiovascular outcomes</term><term>Confidence interval</term><term>Confounders</term><term>Covariate</term><term>Data analysis</term><term>Data collection</term><term>Data interpretation</term><term>December</term><term>Diabetes</term><term>Diabetes mellitus</term><term>Diuretic</term><term>Endpoint</term><term>Extreme weights</term><term>Fasting</term><term>Glucose</term><term>Glucose tolerance</term><term>Glucose tolerance outcomes research</term><term>Hazard ratio</term><term>Heart attack trial</term><term>High risk</term><term>High risk patients</term><term>High risk population</term><term>Hypertension</term><term>Inverse probability</term><term>Lancet</term><term>Manuscript review</term><term>Mellitus</term><term>Model hazard ratio</term><term>Navigator</term><term>Navigator trial</term><term>Novartis</term><term>Onset diabetes</term><term>Oral glucose tolerance test</term><term>Other studies</term><term>Previous studies</term><term>Randomised</term><term>Randomised trial</term><term>Reprint</term><term>Research institute</term><term>Research support</term><term>Risk factors</term><term>Serial glucose measurements</term><term>Statin</term><term>Statin therapy</term><term>Study design</term><term>Treatment initiation</term><term>Treatment patients</term><term>Treatment weighting</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Antihypertensive</term><term>Baseline</term><term>Baseline characteristics</term><term>Baseline variables</term><term>Blocker</term><term>Calcium channel blocker</term><term>Calcium channel blockers</term><term>Cardiovascular</term><term>Cardiovascular events</term><term>Cardiovascular morbidity</term><term>Cardiovascular outcomes</term><term>Confidence interval</term><term>Confounders</term><term>Covariate</term><term>Data analysis</term><term>Data collection</term><term>Data interpretation</term><term>December</term><term>Diabetes</term><term>Diabetes mellitus</term><term>Diuretic</term><term>Endpoint</term><term>Extreme weights</term><term>Fasting</term><term>Glucose</term><term>Glucose tolerance</term><term>Glucose tolerance outcomes research</term><term>Hazard ratio</term><term>Heart attack trial</term><term>High risk</term><term>High risk patients</term><term>High risk population</term><term>Hypertension</term><term>Inverse probability</term><term>Lancet</term><term>Manuscript review</term><term>Mellitus</term><term>Model hazard ratio</term><term>Navigator</term><term>Navigator trial</term><term>Novartis</term><term>Onset diabetes</term><term>Oral glucose tolerance test</term><term>Other studies</term><term>Previous studies</term><term>Randomised</term><term>Randomised trial</term><term>Reprint</term><term>Research institute</term><term>Research support</term><term>Risk factors</term><term>Serial glucose measurements</term><term>Statin</term><term>Statin therapy</term><term>Study design</term><term>Treatment initiation</term><term>Treatment patients</term><term>Treatment weighting</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Collecte de données</term><term>Diabète</term><term>Glucose</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes. Design Reanalysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. Setting NAVIGATOR trial. Participants Patients who at baseline (enrolment) were treatment naïve to β blockers (n=5640), diuretics (n=6346), statins (n=6146), and calcium channel blockers (n=6294). Use of calcium channel blocker was used as a metabolically neutral control. Main outcome measures Development of new onset diabetes diagnosed by standard plasma glucose level in all participants and confirmed with glucose tolerance testing within 12 weeks after the increased glucose value was recorded. The relation between each treatment and new onset diabetes was evaluated using marginal structural models for causal inference, to account for time dependent confounding in treatment assignment. Results During the median five years of follow-up, β blockers were started in 915 (16.2%) patients, diuretics in 1316 (20.7%), statins in 1353 (22.0%), and calcium channel blockers in 1171 (18.6%). After adjusting for baseline characteristics and time varying confounders, diuretics and statins were both associated with an increased risk of new onset diabetes (hazard ratio 1.23, 95% confidence interval 1.06 to 1.44, and 1.32, 1.14 to 1.48, respectively), whereas β blockers and calcium channel blockers were not associated with new onset diabetes (1.10, 0.92 to 1.31, and 0.95, 0.79 to 1.13, respectively). Conclusions Among people with impaired glucose tolerance and other cardiovascular risk factors and with serial glucose measurements, diuretics and statins were associated with an increased risk of new onset diabetes, whereas the effect of β blockers was non-significant. Trial registration ClinicalTrials.gov NCT00097786.</div></front></TEI><double doi="10.1136/bmj.f6745"><ISTEX><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study</title><author><name sortKey="Shen, Lan" sort="Shen, Lan" uniqKey="Shen L" first="Lan" last="Shen">Lan Shen</name></author><author><name sortKey="Shah, Bimal R" sort="Shah, Bimal R" uniqKey="Shah B" first="Bimal R" last="Shah">Bimal R. Shah</name></author><author><name sortKey="Reyes, Eric M" sort="Reyes, Eric M" uniqKey="Reyes E" first="Eric M" last="Reyes">Eric M. Reyes</name></author><author><name sortKey="Thomas, Laine" sort="Thomas, Laine" uniqKey="Thomas L" first="Laine" last="Thomas">Laine Thomas</name></author><author><name sortKey="Wojdyla, Daniel" sort="Wojdyla, Daniel" uniqKey="Wojdyla D" first="Daniel" last="Wojdyla">Daniel Wojdyla</name></author><author><name sortKey="Diem, Peter" sort="Diem, Peter" uniqKey="Diem P" first="Peter" last="Diem">Peter Diem</name></author><author><name sortKey="Leiter, Lawrence A" sort="Leiter, Lawrence A" uniqKey="Leiter L" first="Lawrence A" last="Leiter">Lawrence A. Leiter</name></author><author><name sortKey="Charbonnel, Bernard" sort="Charbonnel, Bernard" uniqKey="Charbonnel B" first="Bernard" last="Charbonnel">Bernard Charbonnel</name></author><author><name sortKey="Mareev, Viacheslav" sort="Mareev, Viacheslav" uniqKey="Mareev V" first="Viacheslav" last="Mareev">Viacheslav Mareev</name></author><author><name sortKey="Horton, Edward S" sort="Horton, Edward S" uniqKey="Horton E" first="Edward S" last="Horton">Edward S. Horton</name></author><author><name sortKey="Haffner, Steven M" sort="Haffner, Steven M" uniqKey="Haffner S" first="Steven M" last="Haffner">Steven M. Haffner</name></author><author><name sortKey="Soska, Vladimir" sort="Soska, Vladimir" uniqKey="Soska V" first="Vladimir" last="Soska">Vladimir Soska</name></author><author><name sortKey="Holman, Rury" sort="Holman, Rury" uniqKey="Holman R" first="Rury" last="Holman">Rury Holman</name></author><author><name sortKey="Bethel, M Angelyn" sort="Bethel, M Angelyn" uniqKey="Bethel M" first="M Angelyn" last="Bethel">M Angelyn Bethel</name></author><author><name sortKey="Schaper, Frank" sort="Schaper, Frank" uniqKey="Schaper F" first="Frank" last="Schaper">Frank Schaper</name></author><author><name sortKey="Sun, Jie Lena" sort="Sun, Jie Lena" uniqKey="Sun J" first="Jie-Lena" last="Sun">Jie-Lena Sun</name></author><author><name sortKey="Mcmurray, John Jv" sort="Mcmurray, John Jv" uniqKey="Mcmurray J" first="John Jv" last="Mcmurray">John Jv Mcmurray</name></author><author><name sortKey="Califf, Robert M" sort="Califf, Robert M" uniqKey="Califf R" first="Robert M" last="Califf">Robert M. Califf</name></author><author><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:3FBB3288FDB8558B560FAFE3A176244F8342DB67</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/bmj.f6745</idno><idno type="url">https://api.istex.fr/document/3FBB3288FDB8558B560FAFE3A176244F8342DB67/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000B89</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000B89</idno><idno type="wicri:Area/Istex/Curation">000B89</idno><idno type="wicri:Area/Istex/Checkpoint">000203</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">000203</idno><idno type="wicri:doubleKey">0959-8138:2013:Shen L:role:of:diuretics</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study</title><author><name sortKey="Shen, Lan" sort="Shen, Lan" uniqKey="Shen L" first="Lan" last="Shen">Lan Shen</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University</wicri:regionArea><wicri:noRegion>Shanghai Jiaotong University</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Shah, Bimal R" sort="Shah, Bimal R" uniqKey="Shah B" first="Bimal R" last="Shah">Bimal R. Shah</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Reyes, Eric M" sort="Reyes, Eric M" uniqKey="Reyes E" first="Eric M" last="Reyes">Eric M. Reyes</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Thomas, Laine" sort="Thomas, Laine" uniqKey="Thomas L" first="Laine" last="Thomas">Laine Thomas</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Wojdyla, Daniel" sort="Wojdyla, Daniel" uniqKey="Wojdyla D" first="Daniel" last="Wojdyla">Daniel Wojdyla</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Diem, Peter" sort="Diem, Peter" uniqKey="Diem P" first="Peter" last="Diem">Peter Diem</name><affiliation wicri:level="4"><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Endocrinology, Diabetes and Clinical Nutrition University Hospital, University of Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region nuts="3" type="region">Canton de Berne</region></placeName><orgName type="university">Université de Berne</orgName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Leiter, Lawrence A" sort="Leiter, Lawrence A" uniqKey="Leiter L" first="Lawrence A" last="Leiter">Lawrence A. Leiter</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>St Michael’s Hospital, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Charbonnel, Bernard" sort="Charbonnel, Bernard" uniqKey="Charbonnel B" first="Bernard" last="Charbonnel">Bernard Charbonnel</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Endocrinology Department, University Hospital, Nantes</wicri:regionArea><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Mareev, Viacheslav" sort="Mareev, Viacheslav" uniqKey="Mareev V" first="Viacheslav" last="Mareev">Viacheslav Mareev</name><affiliation wicri:level="3"><country xml:lang="fr">Russie</country><wicri:regionArea>Lomonosov Moscow State University, Moscow</wicri:regionArea><placeName><settlement type="city">Moscou</settlement><region>District fédéral central</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Horton, Edward S" sort="Horton, Edward S" uniqKey="Horton E" first="Edward S" last="Horton">Edward S. Horton</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Joslin Diabetes Center, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Haffner, Steven M" sort="Haffner, Steven M" uniqKey="Haffner S" first="Steven M" last="Haffner">Steven M. Haffner</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Soska, Vladimir" sort="Soska, Vladimir" uniqKey="Soska V" first="Vladimir" last="Soska">Vladimir Soska</name><affiliation wicri:level="3"><country xml:lang="fr">République tchèque</country><wicri:regionArea>2nd Clinic of Internal Medicine and Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno</wicri:regionArea><placeName><settlement type="city">Brno</settlement><region>Moravie</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Holman, Rury" sort="Holman, Rury" uniqKey="Holman R" first="Rury" last="Holman">Rury Holman</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Bethel, M Angelyn" sort="Bethel, M Angelyn" uniqKey="Bethel M" first="M Angelyn" last="Bethel">M Angelyn Bethel</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Schaper, Frank" sort="Schaper, Frank" uniqKey="Schaper F" first="Frank" last="Schaper">Frank Schaper</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Center for Clinical Studies, Metabolism and Endocrinology Knowledge and Technology Transfer of Dresden University of Technology, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Sun, Jie Lena" sort="Sun, Jie Lena" uniqKey="Sun J" first="Jie-Lena" last="Sun">Jie-Lena Sun</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Mcmurray, John Jv" sort="Mcmurray, John Jv" uniqKey="Mcmurray J" first="John Jv" last="Mcmurray">John Jv Mcmurray</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>British Heart Foundation Cardiovascular Research Centre, University of Glasgow</wicri:regionArea><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName><orgName type="university">Université de Glasgow</orgName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Califf, Robert M" sort="Califf, Robert M" uniqKey="Califf R" first="Robert M" last="Califf">Robert M. Califf</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>Monash Centre of Cardiovascular Research and Education in Therapeutics, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne VIC 3004</wicri:regionArea><wicri:noRegion>Melbourne VIC 3004</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ : British Medical Journal</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1756-1833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2013-12-09">2013-12-09</date><biblScope unit="volume">347</biblScope></imprint><idno type="ISSN">0959-8138</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antihypertensive</term><term>Baseline</term><term>Baseline characteristics</term><term>Baseline variables</term><term>Blocker</term><term>Calcium channel blocker</term><term>Calcium channel blockers</term><term>Cardiovascular</term><term>Cardiovascular events</term><term>Cardiovascular morbidity</term><term>Cardiovascular outcomes</term><term>Confidence interval</term><term>Confounders</term><term>Covariate</term><term>Data analysis</term><term>Data collection</term><term>Data interpretation</term><term>December</term><term>Diabetes</term><term>Diabetes mellitus</term><term>Diuretic</term><term>Endpoint</term><term>Extreme weights</term><term>Fasting</term><term>Glucose</term><term>Glucose tolerance</term><term>Glucose tolerance outcomes research</term><term>Hazard ratio</term><term>Heart attack trial</term><term>High risk</term><term>High risk patients</term><term>High risk population</term><term>Hypertension</term><term>Inverse probability</term><term>Lancet</term><term>Manuscript review</term><term>Mellitus</term><term>Model hazard ratio</term><term>Navigator</term><term>Navigator trial</term><term>Novartis</term><term>Onset diabetes</term><term>Oral glucose tolerance test</term><term>Other studies</term><term>Previous studies</term><term>Randomised</term><term>Randomised trial</term><term>Reprint</term><term>Research institute</term><term>Research support</term><term>Risk factors</term><term>Serial glucose measurements</term><term>Statin</term><term>Statin therapy</term><term>Study design</term><term>Treatment initiation</term><term>Treatment patients</term><term>Treatment weighting</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Antihypertensive</term><term>Baseline</term><term>Baseline characteristics</term><term>Baseline variables</term><term>Blocker</term><term>Calcium channel blocker</term><term>Calcium channel blockers</term><term>Cardiovascular</term><term>Cardiovascular events</term><term>Cardiovascular morbidity</term><term>Cardiovascular outcomes</term><term>Confidence interval</term><term>Confounders</term><term>Covariate</term><term>Data analysis</term><term>Data collection</term><term>Data interpretation</term><term>December</term><term>Diabetes</term><term>Diabetes mellitus</term><term>Diuretic</term><term>Endpoint</term><term>Extreme weights</term><term>Fasting</term><term>Glucose</term><term>Glucose tolerance</term><term>Glucose tolerance outcomes research</term><term>Hazard ratio</term><term>Heart attack trial</term><term>High risk</term><term>High risk patients</term><term>High risk population</term><term>Hypertension</term><term>Inverse probability</term><term>Lancet</term><term>Manuscript review</term><term>Mellitus</term><term>Model hazard ratio</term><term>Navigator</term><term>Navigator trial</term><term>Novartis</term><term>Onset diabetes</term><term>Oral glucose tolerance test</term><term>Other studies</term><term>Previous studies</term><term>Randomised</term><term>Randomised trial</term><term>Reprint</term><term>Research institute</term><term>Research support</term><term>Risk factors</term><term>Serial glucose measurements</term><term>Statin</term><term>Statin therapy</term><term>Study design</term><term>Treatment initiation</term><term>Treatment patients</term><term>Treatment weighting</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Collecte de données</term><term>Diabète</term><term>Glucose</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes. Design Reanalysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. Setting NAVIGATOR trial. Participants Patients who at baseline (enrolment) were treatment naïve to β blockers (n=5640), diuretics (n=6346), statins (n=6146), and calcium channel blockers (n=6294). Use of calcium channel blocker was used as a metabolically neutral control. Main outcome measures Development of new onset diabetes diagnosed by standard plasma glucose level in all participants and confirmed with glucose tolerance testing within 12 weeks after the increased glucose value was recorded. The relation between each treatment and new onset diabetes was evaluated using marginal structural models for causal inference, to account for time dependent confounding in treatment assignment. Results During the median five years of follow-up, β blockers were started in 915 (16.2%) patients, diuretics in 1316 (20.7%), statins in 1353 (22.0%), and calcium channel blockers in 1171 (18.6%). After adjusting for baseline characteristics and time varying confounders, diuretics and statins were both associated with an increased risk of new onset diabetes (hazard ratio 1.23, 95% confidence interval 1.06 to 1.44, and 1.32, 1.14 to 1.48, respectively), whereas β blockers and calcium channel blockers were not associated with new onset diabetes (1.10, 0.92 to 1.31, and 0.95, 0.79 to 1.13, respectively). Conclusions Among people with impaired glucose tolerance and other cardiovascular risk factors and with serial glucose measurements, diuretics and statins were associated with an increased risk of new onset diabetes, whereas the effect of β blockers was non-significant. Trial registration ClinicalTrials.gov NCT00097786.</div></front></TEI></ISTEX><PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study</title><author><name sortKey="Shen, Lan" sort="Shen, Lan" uniqKey="Shen L" first="Lan" last="Shen">Lan Shen</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University</wicri:regionArea><wicri:noRegion>Shanghai Jiaotong University</wicri:noRegion></affiliation></author><author><name sortKey="Shah, Bimal R" sort="Shah, Bimal R" uniqKey="Shah B" first="Bimal R" last="Shah">Bimal R. Shah</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Reyes, Eric M" sort="Reyes, Eric M" uniqKey="Reyes E" first="Eric M" last="Reyes">Eric M. Reyes</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Thomas, Laine" sort="Thomas, Laine" uniqKey="Thomas L" first="Laine" last="Thomas">Laine Thomas</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Wojdyla, Daniel" sort="Wojdyla, Daniel" uniqKey="Wojdyla D" first="Daniel" last="Wojdyla">Daniel Wojdyla</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Diem, Peter" sort="Diem, Peter" uniqKey="Diem P" first="Peter" last="Diem">Peter Diem</name><affiliation wicri:level="4"><nlm:aff id="aff3">Department of Endocrinology, Diabetes and Clinical Nutrition University Hospital, University of Bern, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Endocrinology, Diabetes and Clinical Nutrition University Hospital, University of Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region nuts="3" type="region">Canton de Berne</region></placeName><orgName type="university">Université de Berne</orgName></affiliation></author><author><name sortKey="Leiter, Lawrence A" sort="Leiter, Lawrence A" uniqKey="Leiter L" first="Lawrence A" last="Leiter">Lawrence A. Leiter</name><affiliation wicri:level="1"><nlm:aff id="aff4">St Michael’s Hospital, Toronto, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>St Michael’s Hospital, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Charbonnel, Bernard" sort="Charbonnel, Bernard" uniqKey="Charbonnel B" first="Bernard" last="Charbonnel">Bernard Charbonnel</name><affiliation wicri:level="3"><nlm:aff id="aff5">Endocrinology Department, University Hospital, Nantes, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Endocrinology Department, University Hospital, Nantes</wicri:regionArea><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Mareev, Viacheslav" sort="Mareev, Viacheslav" uniqKey="Mareev V" first="Viacheslav" last="Mareev">Viacheslav Mareev</name><affiliation wicri:level="3"><nlm:aff id="aff6">Lomonosov Moscow State University, Moscow, Russia</nlm:aff><country xml:lang="fr">Russie</country><wicri:regionArea>Lomonosov Moscow State University, Moscow</wicri:regionArea><placeName><settlement type="city">Moscou</settlement><region>District fédéral central</region></placeName></affiliation></author><author><name sortKey="Horton, Edward S" sort="Horton, Edward S" uniqKey="Horton E" first="Edward S" last="Horton">Edward S. Horton</name><affiliation wicri:level="2"><nlm:aff id="aff7">Joslin Diabetes Center, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Joslin Diabetes Center, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Haffner, Steven M" sort="Haffner, Steven M" uniqKey="Haffner S" first="Steven M" last="Haffner">Steven M. Haffner</name><affiliation wicri:level="4"><nlm:aff id="aff8">Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Soska, Vladimir" sort="Soska, Vladimir" uniqKey="Soska V" first="Vladimir" last="Soska">Vladimir Soska</name><affiliation wicri:level="3"><nlm:aff id="aff9">2nd Clinic of Internal Medicine and Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic</nlm:aff><country xml:lang="fr">République tchèque</country><wicri:regionArea>2nd Clinic of Internal Medicine and Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno</wicri:regionArea><placeName><settlement type="city">Brno</settlement><region>Moravie</region></placeName></affiliation></author><author><name sortKey="Holman, Rury" sort="Holman, Rury" uniqKey="Holman R" first="Rury" last="Holman">Rury Holman</name><affiliation wicri:level="3"><nlm:aff id="aff10">Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Bethel, M Angelyn" sort="Bethel, M Angelyn" uniqKey="Bethel M" first="M Angelyn" last="Bethel">M Angelyn Bethel</name><affiliation wicri:level="4"><nlm:aff id="aff8">Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Schaper, Frank" sort="Schaper, Frank" uniqKey="Schaper F" first="Frank" last="Schaper">Frank Schaper</name><affiliation wicri:level="3"><nlm:aff id="aff11">Center for Clinical Studies, Metabolism and Endocrinology Knowledge and Technology Transfer of Dresden University of Technology, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Center for Clinical Studies, Metabolism and Endocrinology Knowledge and Technology Transfer of Dresden University of Technology, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Sun, Jie Lena" sort="Sun, Jie Lena" uniqKey="Sun J" first="Jie-Lena" last="Sun">Jie-Lena Sun</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Mcmurray, John Jv" sort="Mcmurray, John Jv" uniqKey="Mcmurray J" first="John Jv" last="Mcmurray">John Jv Mcmurray</name><affiliation wicri:level="4"><nlm:aff id="aff12">British Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>British Heart Foundation Cardiovascular Research Centre, University of Glasgow</wicri:regionArea><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName><orgName type="university">Université de Glasgow</orgName></affiliation></author><author><name sortKey="Califf, Robert M" sort="Califf, Robert M" uniqKey="Califf R" first="Robert M" last="Califf">Robert M. Califf</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name><affiliation wicri:level="1"><nlm:aff id="aff13">Monash Centre of Cardiovascular Research and Education in Therapeutics, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne VIC 3004, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Monash Centre of Cardiovascular Research and Education in Therapeutics, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne VIC 3004</wicri:regionArea><wicri:noRegion>Melbourne VIC 3004</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24322398</idno><idno type="pmc">3898638</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898638</idno><idno type="RBID">PMC:3898638</idno><idno type="doi">10.1136/bmj.f6745</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">000520</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000520</idno><idno type="wicri:Area/Pmc/Curation">000520</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000520</idno><idno type="wicri:Area/Pmc/Checkpoint">001898</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001898</idno><idno type="wicri:Area/Ncbi/Merge">001639</idno><idno type="wicri:Area/Ncbi/Curation">001639</idno><idno type="wicri:Area/Ncbi/Checkpoint">001639</idno><idno type="wicri:doubleKey">0959-8138:2013:Shen L:role:of:diuretics</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Role of diuretics, β blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study</title><author><name sortKey="Shen, Lan" sort="Shen, Lan" uniqKey="Shen L" first="Lan" last="Shen">Lan Shen</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University</wicri:regionArea><wicri:noRegion>Shanghai Jiaotong University</wicri:noRegion></affiliation></author><author><name sortKey="Shah, Bimal R" sort="Shah, Bimal R" uniqKey="Shah B" first="Bimal R" last="Shah">Bimal R. Shah</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Reyes, Eric M" sort="Reyes, Eric M" uniqKey="Reyes E" first="Eric M" last="Reyes">Eric M. Reyes</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Thomas, Laine" sort="Thomas, Laine" uniqKey="Thomas L" first="Laine" last="Thomas">Laine Thomas</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Wojdyla, Daniel" sort="Wojdyla, Daniel" uniqKey="Wojdyla D" first="Daniel" last="Wojdyla">Daniel Wojdyla</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Diem, Peter" sort="Diem, Peter" uniqKey="Diem P" first="Peter" last="Diem">Peter Diem</name><affiliation wicri:level="4"><nlm:aff id="aff3">Department of Endocrinology, Diabetes and Clinical Nutrition University Hospital, University of Bern, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Endocrinology, Diabetes and Clinical Nutrition University Hospital, University of Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region nuts="3" type="region">Canton de Berne</region></placeName><orgName type="university">Université de Berne</orgName></affiliation></author><author><name sortKey="Leiter, Lawrence A" sort="Leiter, Lawrence A" uniqKey="Leiter L" first="Lawrence A" last="Leiter">Lawrence A. Leiter</name><affiliation wicri:level="1"><nlm:aff id="aff4">St Michael’s Hospital, Toronto, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>St Michael’s Hospital, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Charbonnel, Bernard" sort="Charbonnel, Bernard" uniqKey="Charbonnel B" first="Bernard" last="Charbonnel">Bernard Charbonnel</name><affiliation wicri:level="3"><nlm:aff id="aff5">Endocrinology Department, University Hospital, Nantes, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Endocrinology Department, University Hospital, Nantes</wicri:regionArea><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Mareev, Viacheslav" sort="Mareev, Viacheslav" uniqKey="Mareev V" first="Viacheslav" last="Mareev">Viacheslav Mareev</name><affiliation wicri:level="3"><nlm:aff id="aff6">Lomonosov Moscow State University, Moscow, Russia</nlm:aff><country xml:lang="fr">Russie</country><wicri:regionArea>Lomonosov Moscow State University, Moscow</wicri:regionArea><placeName><settlement type="city">Moscou</settlement><region>District fédéral central</region></placeName></affiliation></author><author><name sortKey="Horton, Edward S" sort="Horton, Edward S" uniqKey="Horton E" first="Edward S" last="Horton">Edward S. Horton</name><affiliation wicri:level="2"><nlm:aff id="aff7">Joslin Diabetes Center, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Joslin Diabetes Center, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Haffner, Steven M" sort="Haffner, Steven M" uniqKey="Haffner S" first="Steven M" last="Haffner">Steven M. Haffner</name><affiliation wicri:level="4"><nlm:aff id="aff8">Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Soska, Vladimir" sort="Soska, Vladimir" uniqKey="Soska V" first="Vladimir" last="Soska">Vladimir Soska</name><affiliation wicri:level="3"><nlm:aff id="aff9">2nd Clinic of Internal Medicine and Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic</nlm:aff><country xml:lang="fr">République tchèque</country><wicri:regionArea>2nd Clinic of Internal Medicine and Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno</wicri:regionArea><placeName><settlement type="city">Brno</settlement><region>Moravie</region></placeName></affiliation></author><author><name sortKey="Holman, Rury" sort="Holman, Rury" uniqKey="Holman R" first="Rury" last="Holman">Rury Holman</name><affiliation wicri:level="3"><nlm:aff id="aff10">Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Churchill Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Bethel, M Angelyn" sort="Bethel, M Angelyn" uniqKey="Bethel M" first="M Angelyn" last="Bethel">M Angelyn Bethel</name><affiliation wicri:level="4"><nlm:aff id="aff8">Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Schaper, Frank" sort="Schaper, Frank" uniqKey="Schaper F" first="Frank" last="Schaper">Frank Schaper</name><affiliation wicri:level="3"><nlm:aff id="aff11">Center for Clinical Studies, Metabolism and Endocrinology Knowledge and Technology Transfer of Dresden University of Technology, Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Center for Clinical Studies, Metabolism and Endocrinology Knowledge and Technology Transfer of Dresden University of Technology, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Sun, Jie Lena" sort="Sun, Jie Lena" uniqKey="Sun J" first="Jie-Lena" last="Sun">Jie-Lena Sun</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Mcmurray, John Jv" sort="Mcmurray, John Jv" uniqKey="Mcmurray J" first="John Jv" last="Mcmurray">John Jv Mcmurray</name><affiliation wicri:level="4"><nlm:aff id="aff12">British Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>British Heart Foundation Cardiovascular Research Centre, University of Glasgow</wicri:regionArea><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName><orgName type="university">Université de Glasgow</orgName></affiliation></author><author><name sortKey="Califf, Robert M" sort="Califf, Robert M" uniqKey="Califf R" first="Robert M" last="Califf">Robert M. Califf</name><affiliation wicri:level="2"><nlm:aff id="aff1">Duke Clinical Research Institute, Durham, NC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Clinical Research Institute, Durham, NC</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name><affiliation wicri:level="1"><nlm:aff id="aff13">Monash Centre of Cardiovascular Research and Education in Therapeutics, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne VIC 3004, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Monash Centre of Cardiovascular Research and Education in Therapeutics, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne VIC 3004</wicri:regionArea><wicri:noRegion>Melbourne VIC 3004</wicri:noRegion></affiliation></author></analytic><series><title level="j">The BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1756-1833</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Objective</bold> To examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes.</p><p><bold>Design</bold> Reanalysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial.</p><p><bold>Setting </bold>NAVIGATOR trial.</p><p><bold>Participants</bold> Patients who at baseline (enrolment) were treatment naïve to β blockers (n=5640), diuretics (n=6346), statins (n=6146), and calcium channel blockers (n=6294). Use of calcium channel blocker was used as a metabolically neutral control.</p><p><bold>Main outcome measures</bold> Development of new onset diabetes diagnosed by standard plasma glucose level in all participants and confirmed with glucose tolerance testing within 12 weeks after the increased glucose value was recorded. The relation between each treatment and new onset diabetes was evaluated using marginal structural models for causal inference, to account for time dependent confounding in treatment assignment.</p><p><bold>Results</bold> During the median five years of follow-up, β blockers were started in 915 (16.2%) patients, diuretics in 1316 (20.7%), statins in 1353 (22.0%), and calcium channel blockers in 1171 (18.6%). After adjusting for baseline characteristics and time varying confounders, diuretics and statins were both associated with an increased risk of new onset diabetes (hazard ratio 1.23, 95% confidence interval 1.06 to 1.44, and 1.32, 1.14 to 1.48, respectively), whereas β blockers and calcium channel blockers were not associated with new onset diabetes (1.10, 0.92 to 1.31, and 0.95, 0.79 to 1.13, respectively).</p><p><bold>Conclusions</bold> Among people with impaired glucose tolerance and other cardiovascular risk factors and with serial glucose measurements, diuretics and statins were associated with an increased risk of new onset diabetes, whereas the effect of β blockers was non-significant.</p><p><bold>Trial registration</bold> ClinicalTrials.gov NCT00097786.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI></PMC></double></record>Pour manipuler ce document sous Unix (Dilib)
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