An inverse association between abdominal aortic aneurysms and diabetes mellitus - the cause remains unknown
A new article published in the journal Ateriosclerosis, Throbosis & Vascular Biology (February 2017) by Danish Diabetes Academy PhD student Katrine Lawaetz Kristensen, investigates whether the degree of glycemia is associated with aneurysm growth.
A STUDY BASED ON THE VIBORG VASCULAR TRIAL
The study was based on Viborg Vascular trial, the randomized clinically controlled screening trial for abdominal aortic aneurysm in men aged 65 to 74 years in the Central Denmark Region. The screening included measurement of the abdominal aorta by ultrasound, analysis of glycated hemoglobin (HbA1c), and follow-up for ≤5 years for aneurysms <5 cm.
MIXED-EFFECT MODELS WERE APPLIED
According to Katrine L. Kristensen, analyses were conducted using mixed-effect models. At baseline, VIVA screening identified 619 individuals (3.3%) with abdominal aortic aneurysms. A total of 103 individuals were referred for vascular evaluation, and after removal of additional individuals, who were lost to follow-up or had missing blood samples, 319 individuals were left. Sixty-one individuals (19.1%) had diabetes mellitus. The median growth rate was 1.7 versus 2.7 mm/y in individuals with and without diabetes mellitus, respectively (P<0.001).
LONG-LASTING ELEVATED BLOOD SUGAR IMPAIRS ANEURYSMAL PROGRESSION
They found a significant inverse association between aneurysmal growth rate and HbA1c in the total study population (P=0.002). Both crude and adjusted analyses identified slower growth for the group with the highest HbA1c tertile compared with the lowest HbA1c tertile. After 3 years, the mean difference was 1.8 mm (confidence interval, 0.98–2.64). "Similar significant differences were observed in subgroup analysis of individuals without self-reported diabetes mellitus, which is our most interesting finding since it leaves out the use of antidiabetics as a potential confounder. This indicates that long-lasting elevated blood sugar impairs aneurysmal progression in individuals with and without known diabetes mellitus", concludes Katrine L. Kristensen.
AUTHORS AND AFFILIATIONS
Kristensen KL1, Dahl M2, Rasmussen LM2, Lindholt JS2.
1the Elitary Research Centre of Individualized Medicine in Arterial Disease (K.L.K., L.M.R., J.S.L.), Department of Cardiac, Thoracic, Vascular Surgery (K.L.K., J.S.L.); The Danish Diabetes Academy (K.L.K.), and Department of Clinical Biochemistry and Pharmacology (L.M.R.), Odense University Hospital, Denmark; and Cardiovascular Research Unit, Region Hospital Viborg, Denmark (M.D., J.S.L.). katrine.lawaetz.kristensen@rsyd.dk.
2the Elitary Research Centre of Individualized Medicine in Arterial Disease (K.L.K., L.M.R., J.S.L.), Department of Cardiac, Thoracic, Vascular Surgery (K.L.K., J.S.L.); The Danish Diabetes Academy (K.L.K.), and Department of Clinical Biochemistry and Pharmacology (L.M.R.), Odense University Hospital, Denmark; and Cardiovascular Research Unit, Region Hospital Viborg, Denmark (M.D., J.S.L.).