Association between Diabetes and Risk of Aortic Dissection: A Case-Control Study in a Chinese Population

Xingwei He,Bei Wang,Yujian Liu,Wanjun Liu,Hesong Zeng,Rong Tan,Tao Wang,Zhuxi Li,Bo Gao,Xintian Liu,Yingmei Feng

doi:10.1371/journal.pone.0142697

Abstract

BackgroundIt is well-recognized that diabetes represents a powerful independent risk factor for cardiovascular diseases. However, very few studies have investigated the relationship between diabetes and risk of aortic dissection (AD).AimThe aim of this case-control study was to evaluate the association between diabetes and risk of AD in Chinese population.MethodsA hospital-based case-control study, consisting of 2160 AD patients and 4320 controls, was conducted in a Chinese population. Demographic, clinical characteristics and risk factors were collected. Diabetes rate of patients with overall AD, Stanford type A AD and type B AD group was compared with that of corresponding matched control groups. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between diabetes and AD risk.ResultsThe prevalence of diabetes was lower in AD cases than that of control subjects, whether it is the overall AD, type A AD or type B AD group (4.7% vs. 10.0%, 2.9% vs. 8.8%, 5.9% vs. 10.9%, all P<0.001). Furthermore, in multivariate model, diabetes was found to be associated with lower AD risk, which not only applies to the overall AD (OR = 0.2, 95%CI: 0.15–0.26), but also type A AD (OR = 0.12, 95% CI: 0.07–0.20) and type B AD (OR = 0.25, 95%CI: 0.18–0.33).ConclusionsWe observed the paradoxical inverse relationship between DM and risk of AD in the Chinese population. These results suggest diabetes may play a protective role in the development of AD. However, further studies are needed to enrich related evidence, especially with regard to underlying mechanisms for these trends.

Highlights

Aortic dissection (AD) is a potentially critical break in the lining of the main arterial outflow from the heart [1]
The prevalence of diabetes was lower in AD cases than that of control subjects, whether it is the overall AD, type A AD or type B AD group (4.7% vs. 10.0%, 2.9% vs. 8.8%, 5.9% vs. 10.9%, all P
In multivariate model, diabetes was found to be associated with lower AD risk, which applies to the overall AD (OR = 0.2, 95%CI: 0.15– 0.26), and type A AD (OR = 0.12, 95% confidence intervals (95% CI): 0.07–0.20) and type B AD (OR = 0.25, 95% CI: 0.18–0.33)

Summary

Introduction

Aortic dissection (AD) is a potentially critical break in the lining of the main arterial outflow from the heart [1]. Diabetes is a high risk factor for the development of cardiovascular diseases (CVD)and atherosclerosis [7, 8]. It has been shown that there exists a significant association between the degree of hyperglycaemia and increased risk of microvascular complications, macrovascular mortality, and all-cause mortality in patients with diabetes [9,10,11,12]. Based on the above analysis, diabetes seemed to be considered as a risk factor for AD. It is well-recognized that diabetes represents a powerful independent risk factor for cardiovascular diseases. Very few studies have investigated the relationship between diabetes and risk of aortic dissection (AD)

Methods

Results

Conclusion