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Published on: September 19, 2018
Association between diabetes and prevalence and growth rate of abdominal aortic aneurysms: A meta-analysis
Jiang Xiong1, Zhongyin Wu1, Chen Chen2
1Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, PR China.
Background:
Although the prevalence of abdominal aortic aneurysm (AAA) was lower in diabetes, the relationship between diabetes and AAA prevalence remains unclear. In this meta-analysis, we sought to clarify the effect of diabetes on prevalence and growth rate (GR) of AAA.
Methods:
We searched PubMed, Web of Science, Scopus and Cochrane databases. Articles reporting the AAA prevalence in diabetic patients and diabetic effects in GR of AAA were included.
Results:
Forty-nine studies on AAA prevalence in diabetics and thirteen studies on effect of diabetes in GR of AAA were included for meta-analysis. A strongly negative association was found between diabetes and AAA prevalence in population based screening (odds ratio [OR]adjusted: 0.66; 95% confidence interval [CI]: 0.58-0.75) and prospective studies (ORadjusted: 0.52; 95% CI: 0.43-0.63), but not in case-control studies (ORadjusted: 0.48; 95% CI: 0.20-1.15). Similar association was found in North American (ORadjusted: 0.62; 95% CI 0.54-0.71) and European (ORadjusted: 0.45; 95% CI 0.33-0.62) studies. The strongly negative association remained consistent after stratification by time of data collection (up to -1995 [ORadjusted: 0.65; 95% CI: 0.53-0.80], 1996-2005 [ORadjusted: 0.61; 95% CI: 0.47-0.78], 2006 and beyond- [ORadjusted: 0.67; 95% CI: 0.53-0.85], and data collection time >10years [ORadjusted: OR: 0.44; 95% CI 0.34-0.58]). The annual mean diabetic effect on AAA GR was -0.60mm/y (95% CI: -0.76 - -0.43).
Conclusion:
Diabetes was strongly and negatively associated with AAA prevalence regardless of study type, geography and time of data collection, as well as negative impact of diabetes on GR of AAA.
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