Document Detail

Losartan reduces the onset of type 2 diabetes in hypertensive Japanese patients with chronic hepatitis C.
MedLine Citation:
PMID:  19623665     Owner:  NLM     Status:  MEDLINE    
The aim of this retrospective cohort study is to assess the cumulative development incidence and predictive factors for type 2 diabetes (T2DM) in HCV positive and hypertensive patients treated with losartan. Eighty Japanese patients were given 50 mg of losartan per day after diagnosis of hypertension (losartan group). Another 160 treated with spironolactone were selected as control (spironolactone group). Patients in spironolactone group were matched 1:2 with losartan group for age and sex. The mean observation period was 5.2 years in losartan group and 5.4 years in spironolactone group. An overnight (12 hr) fasting blood sample or a casual blood sample was taken for routine analyses during follow-up. The primary goal is the onset of T2DM. Evaluation was performed by using the Kaplan-Meier method and the cox proportional hazards analysis. Three patients in losartan group and 20 in spironolactone group developed T2DM. The 5th year cumulative appearance rates of T2DM were 5.4% in losartan group and 14.4% in spironolactone group. Multivariate cox proportional hazards analysis showed that T2DM development after the initiation of anti-hypertensive drugs occurred when anti-hypertensive drug was spironolactone (hazard ratio: 6.10; 95% confidence interval = 1.78-20.84; P = 0.004), histological staging was advanced (hazard ratio: 4.31; 95% confidence interval = 1.94-9.60; P < 0.001), fatty liver was present (hazard ratio: 3.28; 95% confidence interval = 1.47-7.27; P = 0.004), and patient had pre-diabetes (hazard ratio: 2.47; 95% confidence interval = 1.08-5.63; P = 0.032). Our results indicate losartan causes about 60% reduction of the onset of T2DM compared to patients treated with spironolactone.
Yasuji Arase; Fumitaka Suzuki; Yoshiyuki Suzuki; Norio Akuta; Masahiro Kobayashi; Yusuke Kawamura; Hiromi Yatsuji; Hitomi Sezaki; Tetsuya Hosaka; Miharu Hirakawa; Satoshi Saito; Kenji Ikeda; Mariko Kobayashi; Hiromitsu Kumada; Tetsuro Kobayashi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of medical virology     Volume:  81     ISSN:  1096-9071     ISO Abbreviation:  J. Med. Virol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-07-28     Completed Date:  2009-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7705876     Medline TA:  J Med Virol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1584-90     Citation Subset:  IM    
Department of Hepatology, Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan.
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MeSH Terms
Antihypertensive Agents / administration & dosage,  therapeutic use*
Asian Continental Ancestry Group
Case-Control Studies
Data Interpretation, Statistical
Diabetes Mellitus, Type 2 / prevention & control*
Hepatitis C, Chronic / complications*
Hypertension / drug therapy*
Longitudinal Studies
Losartan / administration & dosage,  therapeutic use*
Middle Aged
Spironolactone / therapeutic use
Reg. No./Substance:
0/Antihypertensive Agents; 114798-26-4/Losartan; 52-01-7/Spironolactone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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