Reuban T D'cruz1, Ian J Y Wee2, Nicholas L Syn2, Andrew M T L Choong3. 1. SingVaSC, Singapore Vascular Surgical Collaborative, Singapore; Department of Surgery, National University Hospital, Singapore. Electronic address: reubantoby.d'cruz@mohh.com.sg. 2. SingVaSC, Singapore Vascular Surgical Collaborative, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 3. SingVaSC, Singapore Vascular Surgical Collaborative, Singapore; Cardiovascular Research Institute, National University of Singapore, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Vascular Surgery, National University Heart Centre, Singapore.
Abstract
OBJECTIVE: The negative correlation between diabetes mellitus (DM) and abdominal aortic aneurysms (AAAs) is well described. The etiologic similarities and differences between AAAs and thoracic aortic aneurysms (TAAs) have also been documented. We aimed to evaluate the relationship between DM and TAA by performing a meta-analysis of contemporary clinical studies. METHODS: A systematic search of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to investigate the relationship of DM and TAA. Data from population cohort and case-control studies were extracted and computed together to determine a pooled unadjusted odds ratio (OR) with corresponding 95% confidence intervals (CIs) using random-effects meta-analysis. RESULTS: Five population cohort studies and five case-control studies involving 1,006,360 patients met eligibility requirement and were included. Unadjusted pooled analysis of all 10 studies demonstrated an inverse association of DM with TAA (OR, 0.77; 95% CI, 0.61-0.98). Primary analysis of the five cohort studies demonstrated a statistically significant negative association between DM and TAA (OR, 0.70; 95% CI, 0.59-0.84). However, primary analysis of the five case-control studies demonstrated a negative association between DM and TAA (OR, 0.86; 95% CI, 0.50-1.47) with no statistical significance. CONCLUSIONS: This meta-analysis demonstrated a statistically significant inverse association between DM and TAA, similar to that of AAA. Further research is required into the potentially protective mechanisms that DM may confer and whether there is biologic plausibility to exploit these mechanisms further to prevent aneurysm expansion and rupture.
OBJECTIVE: The negative correlation between diabetes mellitus (DM) and abdominal aortic aneurysms (AAAs) is well described. The etiologic similarities and differences between AAAs and thoracic aortic aneurysms (TAAs) have also been documented. We aimed to evaluate the relationship between DM and TAA by performing a meta-analysis of contemporary clinical studies. METHODS: A systematic search of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to investigate the relationship of DM and TAA. Data from population cohort and case-control studies were extracted and computed together to determine a pooled unadjusted odds ratio (OR) with corresponding 95% confidence intervals (CIs) using random-effects meta-analysis. RESULTS: Five population cohort studies and five case-control studies involving 1,006,360 patients met eligibility requirement and were included. Unadjusted pooled analysis of all 10 studies demonstrated an inverse association of DM with TAA (OR, 0.77; 95% CI, 0.61-0.98). Primary analysis of the five cohort studies demonstrated a statistically significant negative association between DM and TAA (OR, 0.70; 95% CI, 0.59-0.84). However, primary analysis of the five case-control studies demonstrated a negative association between DM and TAA (OR, 0.86; 95% CI, 0.50-1.47) with no statistical significance. CONCLUSIONS: This meta-analysis demonstrated a statistically significant inverse association between DM and TAA, similar to that of AAA. Further research is required into the potentially protective mechanisms that DM may confer and whether there is biologic plausibility to exploit these mechanisms further to prevent aneurysm expansion and rupture.
Authors: Carl Granath; David Freiholtz; Fredrik Bredin; Christian Olsson; Anders Franco-Cereceda; Hanna M Björck Journal: J Am Heart Assoc Date: 2022-04-26 Impact factor: 6.106
Authors: M J P van Hout; J F Juffermans; H J Lamb; E S J Kröner; P J van den Boogaard; M J Schalij; I A Dekkers; A J Scholte; J J Westenberg Journal: Int J Cardiol Heart Vasc Date: 2021-12-13