The association between diabetes and thoracic aortic aneurysms

• Published in: Journal of vascular surgery 2019-01, Vol.69 (1), p.263-268.e1
• Main Authors: D'cruz, Reuban T., Wee, Ian J.Y., Syn, Nicholas L., Choong, Andrew M.T.L.
• Format: Article
• Language: English
• Subjects: Aortic aneurysm; Diabetes mellitus; Thoracic aortic aneurysm
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2018.07.031

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. 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. 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. 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.