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Published on: July 5, 2024
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Diabetes and abdominal aortic aneurysms.
P De Rango1, L Farchioni1, B Fiorucci1
1Vascular and Endovascular Surgery Unit, Hospital S. Maria Misericordia, University of Perugia, Perugia, Italy.
Summary
Diabetes appears to lower the risk of abdominal aortic aneurysm (AAA) development and growth. However, diabetic patients face higher mortality risks after AAA repair, suggesting individualized treatment approaches.
Area of Science:
- Cardiovascular Surgery
- Endovascular Surgery
- Vascular Surgery
- Diabetology
Background:
- Epidemiologic data suggest a potential inverse relationship between diabetes and abdominal aortic aneurysm (AAA) incidence.
- The precise impact of diabetes on AAA development, progression, and clinical outcomes remains incompletely understood.
Purpose of the Study:
- To systematically review and meta-analyze current evidence on the association between diabetes and abdominal aortic aneurysm (AAA).
- To evaluate diabetes' influence on AAA prevalence, incidence, clinical outcomes, and expansion rates.
Main Methods:
- Systematic review of literature published within the last 20 years, utilizing PubMed and Cochrane databases.
- Meta-analysis of 64 identified studies using the generic inverse variance method.
- Assessment of methodological quality using the Newcastle-Ottawa scale.
Main Results:
- A significant inverse association between diabetes and AAA prevalence was observed (pooled OR 0.80).
- A lower pooled incidence of new AAA in diabetic individuals was found (OR 0.54).
- Diabetic patients exhibited increased operative mortality post-AAA repair (pooled OR 1.26) and lower long-term survival rates.
Conclusions:
- Evidence supports an inverse relationship between diabetes and AAA development/enlargement, though study quality varies.
- Diabetic patients have poorer outcomes after AAA repair, indicating a higher cardiovascular burden.
- Individualized treatment strategies for AAA repair in selected diabetic populations may be warranted.
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