The association between diabetes and abdominal aortic aneurysms in men: results of two Danish screening studies, a systematic review, and a meta-analysis of population-based screening studies.
Abdominal aortic aneurysm
Computerised tomography (CT)
Meta-analysis
Screening
Ultrasound
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
16 03 2023
16 03 2023
Historique:
received:
28
06
2021
accepted:
01
03
2023
entrez:
17
3
2023
pubmed:
18
3
2023
medline:
21
3
2023
Statut:
epublish
Résumé
A paradoxical protective effect of diabetes on the development and progression of abdominal aortic aneurysms (AAA) has been known for years. This study aimed to investigate whether the protective role of diabetes on AAAs has evolved over the years. A cross-sectional study, a systematic review and meta-analysis. This study was based on two large, population-based, randomised screening trials of men aged 65-74; VIVA (2008-2011) and DANCAVAS (2014-2018), including measurement of the abdominal aorta by ultrasound or CT, respectively. Analyses were performed using multiple logistic regressions to estimate the odds ratios (ORs) for AAAs in men with diabetes compared to those not having diabetes. Moreover, a systematic review and meta-analysis of population-based screening studies of AAAs to visualise a potential change of the association between diabetes and AAAs. Studies reporting only on women or Asian populations were excluded. In VIVA, the prevalence of AAA was 3.3%, crude OR for AAA in men with diabetes 1.04 (95% confidence interval, CI, 0.80-1.34), and adjusted OR 0.64 (CI 0.48-0.84). In DANCAVAS, the prevalence of AAA was 4.2%, crude OR 1.44 (CI 1.11-1.87), and adjusted OR 0.78 (CI 0.59-1.04). Twenty-three studies were identified for the meta-analysis (N = 224 766). The overall crude OR was 0.90 (CI 0.77-1.05) before 2000 and 1.16 (CI 1.03-1.30) after 1999. The overall adjusted OR was 0.63 (CI 0.59-0.69) before 2000 and 0.69 (CI 0.57-0.84) after 1999. Both the crude and adjusted OR showed a statistically non-significant trend towards an increased risk of AAA by the presence of diabetes. If this represents an actual trend, it could be due to a change in the diabetes population. DANCAVAS: Current Controlled Trials: ISRCTN12157806. VIVA: ClinicalTrials.gov NCT00662480.
Sections du résumé
BACKGROUND
A paradoxical protective effect of diabetes on the development and progression of abdominal aortic aneurysms (AAA) has been known for years. This study aimed to investigate whether the protective role of diabetes on AAAs has evolved over the years.
METHODS
A cross-sectional study, a systematic review and meta-analysis. This study was based on two large, population-based, randomised screening trials of men aged 65-74; VIVA (2008-2011) and DANCAVAS (2014-2018), including measurement of the abdominal aorta by ultrasound or CT, respectively. Analyses were performed using multiple logistic regressions to estimate the odds ratios (ORs) for AAAs in men with diabetes compared to those not having diabetes. Moreover, a systematic review and meta-analysis of population-based screening studies of AAAs to visualise a potential change of the association between diabetes and AAAs. Studies reporting only on women or Asian populations were excluded.
RESULTS
In VIVA, the prevalence of AAA was 3.3%, crude OR for AAA in men with diabetes 1.04 (95% confidence interval, CI, 0.80-1.34), and adjusted OR 0.64 (CI 0.48-0.84). In DANCAVAS, the prevalence of AAA was 4.2%, crude OR 1.44 (CI 1.11-1.87), and adjusted OR 0.78 (CI 0.59-1.04). Twenty-three studies were identified for the meta-analysis (N = 224 766). The overall crude OR was 0.90 (CI 0.77-1.05) before 2000 and 1.16 (CI 1.03-1.30) after 1999. The overall adjusted OR was 0.63 (CI 0.59-0.69) before 2000 and 0.69 (CI 0.57-0.84) after 1999.
CONCLUSION
Both the crude and adjusted OR showed a statistically non-significant trend towards an increased risk of AAA by the presence of diabetes. If this represents an actual trend, it could be due to a change in the diabetes population.
TRIAL REGISTRATION
DANCAVAS: Current Controlled Trials: ISRCTN12157806. VIVA: ClinicalTrials.gov NCT00662480.
Identifiants
pubmed: 36927295
doi: 10.1186/s12872-023-03160-8
pii: 10.1186/s12872-023-03160-8
pmc: PMC10022183
doi:
Banques de données
ClinicalTrials.gov
['NCT00662480']
Types de publication
Systematic Review
Meta-Analysis
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
139Informations de copyright
© 2023. The Author(s).
Références
Eur J Vasc Endovasc Surg. 1995 Aug;10(2):207-10
pubmed: 7655973
Trials. 2010 May 27;11:67
pubmed: 20507582
Am Heart J. 2010 Feb;159(2):307-13
pubmed: 20152231
Br J Surg. 1993 Nov;80(11):1406-9
pubmed: 8252350
Int J Cardiovasc Imaging. 2016 Aug;32(8):1213-7
pubmed: 27215751
Eur J Vasc Endovasc Surg. 2016 Jul;52(1):75-81
pubmed: 27252078
J Gen Intern Med. 2020 May;35(5):1427-1434
pubmed: 31898135
Rev Hosp Clin Fac Med Sao Paulo. 2003 Mar-Apr;58(2):63-8
pubmed: 12845357
Circulation. 2008 Feb 26;117(8):1010-7
pubmed: 18268154
Arch Intern Med. 2000 May 22;160(10):1425-30
pubmed: 10826454
Eur J Vasc Endovasc Surg. 2018 May;55(5):633-639
pubmed: 29506942
J Cardiovasc Surg (Torino). 2010 Dec;51(6):777-82
pubmed: 21124273
Eur J Vasc Surg. 1991 Feb;5(1):53-7
pubmed: 2009986
Ann Intern Med. 1997 Mar 15;126(6):441-9
pubmed: 9072929
Eur J Vasc Endovasc Surg. 2009 Dec;38(6):748-9
pubmed: 19666232
Eur J Vasc Endovasc Surg. 2013 Oct;46(4):453-9
pubmed: 23978561
BMJ Open. 2016 Feb 08;6(2):e010155
pubmed: 26857106
J Vasc Surg. 2016 Jul;64(1):46-54.e8
pubmed: 27106243
Br J Surg. 2019 Jun;106(7):862-871
pubmed: 30919411
J Vasc Surg. 2017 Sep;66(3):768-774.e2
pubmed: 28506478
Scand J Public Health. 2011 Jul;39(7 Suppl):175-9
pubmed: 21775379
Eur J Vasc Endovasc Surg. 2007 May;33(5):599-604
pubmed: 17307366
Br J Surg. 2015 Jul;102(8):902-6
pubmed: 25923784
J Am Heart Assoc. 2017 May 10;6(5):
pubmed: 28490522
Ann Vasc Surg. 2016 Oct;36:55-63
pubmed: 27364735
Trials. 2015 Dec 05;16:554
pubmed: 26637993
PLoS One. 2017 Apr 28;12(4):e0176877
pubmed: 28453577
Ann Vasc Surg. 1998 Nov;12(6):544-9
pubmed: 9841684
Circulation. 2011 Sep 6;124(10):1118-23
pubmed: 21844079
J Vasc Surg. 2019 Mar;69(3):710-716.e3
pubmed: 30197158
Am J Prev Med. 2018 Oct;55(4):497-505
pubmed: 30126668
Cardiovasc Diabetol. 2016 Sep 01;15(1):125
pubmed: 27585542
Int J Cardiol. 2016 Oct 15;221:484-95
pubmed: 27414727
J Clin Epidemiol. 2009 Oct;62(10):e1-34
pubmed: 19631507
Arterioscler Thromb Vasc Biol. 2017 Apr;37(4):730-736
pubmed: 28183702
Clin Epidemiol. 2016 Oct 14;8:381-387
pubmed: 27789974
BMJ. 2012 May 04;344:e2958
pubmed: 22563092
J Vasc Surg. 2009 Jul;50(1):23-9
pubmed: 19563951
Diabetes Obes Metab. 2015 Aug;17(8):771-80
pubmed: 25929277
Eur J Vasc Endovasc Surg. 2018 Aug;56(2):282-290
pubmed: 29891436
J Vasc Surg. 2010 Jul;52(1):55-61.e2
pubmed: 20620765
Scand J Public Health. 2011 Jul;39(7 Suppl):38-41
pubmed: 21775349
Am J Epidemiol. 1995 Dec 15;142(12):1291-9
pubmed: 7503049
J Med Screen. 1996;3(4):208-10
pubmed: 9041487
Angiology. 2018 Mar;69(3):205-211
pubmed: 28193091
Br J Surg. 2017 Oct;104(11):1486-1493
pubmed: 28650557
Ann Vasc Surg. 2013 Nov;27(8):1068-73
pubmed: 24011812
Am J Epidemiol. 2004 May 15;159(10):945-9
pubmed: 15128606