Association between diabetes and prevalence and growth rate of abdominal aortic aneurysms: A meta-analysis

Abstract

BackgroundAlthough 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. MethodsWe 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. ResultsForty-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). ConclusionDiabetes 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.