Morphological Differences in the Abdominal Aorta Between Subjects With and Without Type 2 Diabetes.

Area of Science:

• Cardiovascular Imaging
• Endocrinology
• Vascular Biology

Background:

• Chronic hyperglycemia is a risk factor for macrovascular complications.
• Hyperglycemia's role in abdominal aortic aneurysms is debated, with some reports suggesting a protective effect.
• Understanding diabetes-related aortic morphology is crucial for risk assessment.

Purpose of the Study:

• To investigate morphological differences in the abdominal aorta in patients with type 2 diabetes mellitus (T2DM) compared to non-diabetic individuals.
• To correlate computed tomography (CT) imaging findings with diabetes-related parameters.
• To identify imaging biomarkers associated with T2DM and aortic changes.

Main Methods:

• Retrospective analysis of CT scans in T2DM and non-diabetes mellitus (NDM) subjects without abdominal aortic aneurysm.
• Quantitative assessment of abdominal aortic diameter and wall thickness using contrast-enhanced CT.
• Statistical correlation analysis between imaging findings and clinical/diabetes-related parameters (e.g., HbA1c, intima-media thickness).

Main Results:

• Subjects with T2DM exhibited a significantly smaller abdominal aortic diameter compared to NDM subjects (p=0.026).
• Abdominal aortic wall thickness was significantly greater in T2DM subjects (p=0.011).
• HbA1c was an independent negative predictor of aortic diameter, while the Brinkmann index independently predicted aortic wall thickness.

Conclusions:

• T2DM is associated with distinct abdominal aortic imaging characteristics: smaller diameter and increased wall thickness.
• Aortic wall thickening in T2DM patients correlates with intima-media thickness (IMT), suggesting shared pathophysiological mechanisms.
• These findings highlight the need for vigilant screening for other macrovascular complications in T2DM patients presenting with these aortic imaging features.