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Risk factors for thoracic aortic aneurysm and dissection among diabetic patients: a nationwide population-based study
Suk Kyung Lim1, Kyungdo Han2, Jun Ho Lee3
1Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Frontiers in Cardiovascular Medicine
|October 23, 2025
Summary
Longer diabetes duration and metformin use may reduce the risk of thoracic aortic aneurysm and dissection (TAAD) in patients with type 2 diabetes. Further research is needed on glucose control and treatment strategies.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Public Health
Background:
- Diabetes mellitus (DM) is linked to a reduced risk of thoracic aortic aneurysm and dissection (TAAD).
- However, specific risk factors for TAAD in diabetic individuals are not well-defined.
- This study investigates diabetes-specific risk factors for TAAD development.
Purpose of the Study:
- To identify diabetes-specific risk factors for TAAD in patients with type 2 DM.
- To analyze the association between antidiabetic medications and TAAD risk.
- To provide insights for TAAD prevention strategies in diabetic populations.
Main Methods:
- A population-based cohort study using the Korean National Health Insurance Service database.
- Inclusion of 2,328,347 patients with type 2 DM diagnosed between 2009-2012.
- Follow-up until December 31, 2019, with Cox proportional-hazards regression models to identify risk factors.
Main Results:
- TAAD was diagnosed in 0.02% of the study cohort.
- Increased TAAD risk was associated with older age and male sex.
- Longer diabetes duration and metformin use were associated with decreased TAAD risk.
Conclusions:
- Longer diabetes duration and metformin use may be protective factors against TAAD in type 2 DM patients.
- Further investigation into glucose control and treatment strategies is warranted.
- Findings may inform TAAD risk management in diabetic populations.
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