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In several studies, increase in the incidence of new-onset diabetes (NOD) associated with statin medication has been reported. There have been several reports showing that renin-aldosterone system (RAS) blocker is associated with prevention of new-onset diabetes mellitus (NODM). However, there are limited data regarding comparison for the change of HOmeostasis Model Assessment Insulin Resistance (HOMA-IR) index among angiotensin converting enzyme inhibitor (ACEI) plus statin, angiotensin II receptor blocker (ARB) plus statin, and calcium channel blocker (CCB) plus statin medication.
Finally, the enrolled patients was totally 757 pts. The patients were classified into three groups; ARB plus statin, n=166; ACEI plus statin, n=94; CCB plus statin, n=497.
The mean follow-up of each group was 584.7±249.9 in ARB, 449.6±255.9 in ACEI, and 634.6±267.1 day in CCB. The HOMA-IR value was 0.110±2.693 in ARB, -0.009±3.686 in ACEI, and 0.819±2.235 in CCB (p=0.029, ANOVA). In post hoc analysis, the change of HOMA-IR in the ARB and ACEI group was significantly lower than the CCB group (p=0.012 and p=0.006, respectively by Bonferroni). However, the change of HOMA-R was similar between ARB and ACEI (p=1.000) (Fig).
In the present study, ARB and ACEI medication was more effective with the increase of the HOMA-IR compared to CCB in patient with statin medication.