Abstract
IntroductionEpidemiological studies have highlighted a negative association between diabetes and abdominal aortic aneurysm (AAA). The aim of this study was to investigate the association between insulin resistance and AAA size.Materials and methodsThis prospective cross sectional monocentric study analysed fasting blood samples from 55 patients with AAA eligible for surgical repair. They were divided into 2 groups according to the median AAA diameter: diameter < 50 mm (N = 28) and diameter > 50 mm (N = 27). The median ages were respectively 73 years (62 - 79) and 72 years (67 - 81). Glucose and fructosamine concentrations were determined by spectrophotometry; insulin and C-peptide using chemiluminescent technology. Homeostasis model assessment 2 calculator was used to estimate insulin resistance index (HOMA2 IR).ResultsThere was no significant difference for fasting glucose concentration between the groups (6.1 vs. 5.9 mmol/L, P = 0.825). C-peptide and insulin concentrations, as well as HOMA2 IR index were significantly higher in patients with AAA > 50 mm (0.82 vs. 0.54 nmol/L, P = 0.012; 9 vs. 5 mU/L, P = 0.019 and 1.72 vs. 1.26, P = 0.028, respectively). No linear correlation was identified between AAA diameter and HOMA2 IR. Fructosamine concentration was lower in patients with AAA > 50 mm (225.5 vs. 251 μmol/L, P = 0.005) and negatively correlated with AAA diameter (r = - 0.54, P < 0.001).ConclusionThis study evidenced an association between AAA diameter and insulin resistance. Further studies are required to determine a causal link between insulin resistance and AAA development.
Highlights
Epidemiological studies have highlighted a negative association between diabetes and abdominal aortic aneurysm (AAA)
C-peptide and insulin concentrations, as well as Homeostasis model assessment 2 (HOMA2) IR index were significantly higher in patients with AAA > 50 mm (0.82 vs. 0.54 nmol/L, P = 0.012; 9 vs. 5 mU/L, P = 0.019 and 1.72 vs. 1.26, P = 0.028, respectively)
No linear correlation was identified between AAA diameter and HOMA2 IR
Summary
Epidemiological studies have highlighted a negative association between diabetes and abdominal aortic aneurysm (AAA). Abdominal aortic aneurysm (AAA), generally defined as a focal dilatation of the aorta superior to 30 mm in diameter, represents a life-threatening disease [1]. Despite advances in the management of patients, specific pharmacological approaches to treat and limit aneurysm expansion are still lacking and the only curative therapeutic option relies on surgical interventions including open and endovascular surgery [1,2]. Symptomatic aneurysms, which are often manifested by abdominal or back pain, or rupture, should be promptly treated [1]. There is general agreement that small aneurysms (< 40 mm in diameter) and at low risk of rupture should be monitored, whereas bigger aneurysms (> 54 mm) or at high risk of rupture should be repaired [1]
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