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 : 000520 ( Pmc/Curation ); précédent : 000519; suivant : 000521Role 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] ; Lawrence A. Leiter [Canada] ; Bernard Charbonnel [France] ; Viacheslav Mareev [Russie] ; Edward S. Horton [États-Unis] ; Steven M. Haffner [Royaume-Uni] ; Vladimir Soska [République tchèque] ; Rury Holman [Royaume-Uni] ; M Angelyn Bethel [Royaume-Uni] ; Frank Schaper [Allemagne] ; Jie-Lena Sun [États-Unis] ; John Jv Mcmurray [Royaume-Uni] ; Robert M. Califf [États-Unis] ; Henry Krum [Australie]Source :
- The BMJ [ 0959-8138 ] ; 2013.
Abstract
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DOI: 10.1136/bmj.f6745
PubMed: 24322398
PubMed Central: 3898638
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<record><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="1"><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></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></affiliation></author><author><name sortKey="Shah, Bimal R" sort="Shah, Bimal R" uniqKey="Shah B" first="Bimal R" last="Shah">Bimal R. 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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></affiliation></author><author><name sortKey="Charbonnel, Bernard" sort="Charbonnel, Bernard" uniqKey="Charbonnel B" first="Bernard" last="Charbonnel">Bernard Charbonnel</name><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Mareev, Viacheslav" sort="Mareev, Viacheslav" uniqKey="Mareev V" first="Viacheslav" last="Mareev">Viacheslav Mareev</name><affiliation wicri:level="1"><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></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="1"><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></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="1"><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></affiliation></author><author><name sortKey="Soska, Vladimir" sort="Soska, Vladimir" uniqKey="Soska V" first="Vladimir" last="Soska">Vladimir Soska</name><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Holman, Rury" sort="Holman, Rury" uniqKey="Holman R" first="Rury" last="Holman">Rury Holman</name><affiliation wicri:level="1"><nlm:aff id="aff10">Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Churchill Hospital, Oxford</wicri:regionArea></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="1"><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></affiliation></author><author><name sortKey="Schaper, Frank" sort="Schaper, Frank" uniqKey="Schaper F" first="Frank" last="Schaper">Frank Schaper</name><affiliation wicri:level="1"><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></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="1"><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></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="1"><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></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="1"><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></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></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></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="1"><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></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></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="1"><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></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="1"><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></affiliation></author><author><name sortKey="Thomas, Laine" sort="Thomas, Laine" uniqKey="Thomas L" first="Laine" last="Thomas">Laine Thomas</name><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Wojdyla, Daniel" sort="Wojdyla, Daniel" uniqKey="Wojdyla D" first="Daniel" last="Wojdyla">Daniel Wojdyla</name><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Diem, Peter" sort="Diem, Peter" uniqKey="Diem P" first="Peter" last="Diem">Peter Diem</name><affiliation wicri:level="1"><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></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></affiliation></author><author><name sortKey="Charbonnel, Bernard" sort="Charbonnel, Bernard" uniqKey="Charbonnel B" first="Bernard" last="Charbonnel">Bernard Charbonnel</name><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Mareev, Viacheslav" sort="Mareev, Viacheslav" uniqKey="Mareev V" first="Viacheslav" last="Mareev">Viacheslav Mareev</name><affiliation wicri:level="1"><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></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="1"><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></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="1"><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></affiliation></author><author><name sortKey="Soska, Vladimir" sort="Soska, Vladimir" uniqKey="Soska V" first="Vladimir" last="Soska">Vladimir Soska</name><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Holman, Rury" sort="Holman, Rury" uniqKey="Holman R" first="Rury" last="Holman">Rury Holman</name><affiliation wicri:level="1"><nlm:aff id="aff10">Churchill Hospital, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Churchill Hospital, Oxford</wicri:regionArea></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="1"><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></affiliation></author><author><name sortKey="Schaper, Frank" sort="Schaper, Frank" uniqKey="Schaper F" first="Frank" last="Schaper">Frank Schaper</name><affiliation wicri:level="1"><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></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="1"><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></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="1"><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></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="1"><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></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></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 article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ</journal-id><journal-id journal-id-type="iso-abbrev">BMJ</journal-id><journal-id journal-id-type="publisher-id">bmj</journal-id><journal-title-group><journal-title>The BMJ</journal-title></journal-title-group><issn pub-type="ppub">0959-8138</issn><issn pub-type="epub">1756-1833</issn><publisher><publisher-name>BMJ Publishing Group Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24322398</article-id><article-id pub-id-type="pmc">3898638</article-id><article-id pub-id-type="publisher-id">shel011154</article-id><article-id pub-id-type="doi">10.1136/bmj.f6745</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-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</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Shen</surname><given-names>Lan</given-names></name><role>cardiology fellow</role><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Shah</surname><given-names>Bimal R</given-names></name><role>assistant professor of medicine</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Reyes</surname><given-names>Eric M</given-names></name><role>assistant professor of biostatistics and bioinformatics</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Thomas</surname><given-names>Laine</given-names></name><role>assistant professor of biostatistics and bioinformatics</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Wojdyla</surname><given-names>Daniel</given-names></name><role>statistician</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Diem</surname><given-names>Peter</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Leiter</surname><given-names>Lawrence A</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Charbonnel</surname><given-names>Bernard</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Mareev</surname><given-names>Viacheslav</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Horton</surname><given-names>Edward S</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Haffner</surname><given-names>Steven M</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff8">8</xref></contrib><contrib contrib-type="author"><name><surname>Soska</surname><given-names>Vladimir</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff9">9</xref></contrib><contrib contrib-type="author"><name><surname>Holman</surname><given-names>Rury</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff10">10</xref></contrib><contrib contrib-type="author"><name><surname>Bethel</surname><given-names>M Angelyn</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff8">8</xref></contrib><contrib contrib-type="author"><name><surname>Schaper</surname><given-names>Frank</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Sun</surname><given-names>Jie-Lena</given-names></name><role>statistician</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>McMurray</surname><given-names>John JV</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff12">12</xref></contrib><contrib contrib-type="author"><name><surname>Califf</surname><given-names>Robert M</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Krum</surname><given-names>Henry</given-names></name><role>professor of medicine</role><xref ref-type="aff" rid="aff13">13</xref></contrib><aff id="aff1"><label>1</label>Duke Clinical Research Institute, Durham, NC, USA</aff><aff id="aff2"><label>2</label>Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University, China</aff><aff id="aff3"><label>3</label>Department of Endocrinology, Diabetes and Clinical Nutrition University Hospital, University of Bern, Switzerland</aff><aff id="aff4"><label>4</label>St Michael’s Hospital, Toronto, Ontario, Canada</aff><aff id="aff5"><label>5</label>Endocrinology Department, University Hospital, Nantes, France</aff><aff id="aff6"><label>6</label>Lomonosov Moscow State University, Moscow, Russia</aff><aff id="aff7"><label>7</label>Joslin Diabetes Center, Boston, MA, USA</aff><aff id="aff8"><label>8</label>Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK</aff><aff id="aff9"><label>9</label>2nd Clinic of Internal Medicine and Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic</aff><aff id="aff10"><label>10</label>Churchill Hospital, Oxford, UK</aff><aff id="aff11"><label>11</label>Center for Clinical Studies, Metabolism and Endocrinology Knowledge and Technology Transfer of Dresden University of Technology, Dresden, Germany</aff><aff id="aff12"><label>12</label>British Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK</aff><aff id="aff13"><label>13</label>Monash Centre of Cardiovascular Research and Education in Therapeutics, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne VIC 3004, Australia</aff></contrib-group><author-notes><corresp>Correspondence to: H Krum <email>henry.krum@monash.edu</email></corresp></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>9</day><month>12</month><year>2013</year></pub-date><volume>347</volume><elocation-id>f6745</elocation-id><history><date date-type="accepted"><day>30</day><month>10</month><year>2013</year></date></history><permissions><copyright-statement>© Shen et al 2013</copyright-statement><copyright-year>2013</copyright-year><copyright-holder>Shen et al</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>.</license-p></license></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="bmj.f6745.pdf"></self-uri><abstract><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></abstract></article-meta><notes notes-type="data-supplement"><label>Web Extra</label><title>Extra material supplied by the author</title><supplementary-material content-type="local-data"><caption><p>Supplementary information</p></caption><media xlink:href="shel011154.ww1_default.pdf"><caption><p>Click here for additional data file.</p></caption></media></supplementary-material></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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