Department of Neurology, University Hospital North Norway, N-9038 Tromsø, Norway.
Arterioscler Thromb Vasc Biol. 2010 Jun;30(6):1263-8. doi: 10.1161/ATVBAHA.110.203588. Epub 2010 Apr 1.
The pathogenesis of abdominal aortic aneurysm (AAA) formation is poorly understood. We investigated the relationship between carotid, femoral, and coronary atherosclerosis and abdominal aortic diameter, and whether atherosclerosis was a risk marker for AAA.
Ultrasound of the right carotid artery, the common femoral artery, and the abdominal aorta was performed in 6446 men and women from a general population. The burden of atherosclerosis was assessed as carotid total plaque area, common femoral lumen diameter, and self-reported coronary heart disease. An AAA was defined as maximal infrarenal aortic diameter > or =30 mm. No dose-response relationship was found between carotid atherosclerosis and abdominal aortic diameter <27 mm. However, significantly more atherosclerosis and coronary heart disease was found in aortic diameter > or =27 mm and in AAAs. The age- and sex-adjusted odds ratio (OR) (95% CI) for AAA in the top total plaque area quintile was 2.3 (1.5 to 3.4), as compared with subjects without plaques. The adjusted OR (95% CI) was 1.7 (1.1 to 2.6). No independent association was found between femoral lumen diameter and AAA.
The lack of a consistent dose-response relationship between atherosclerosis and abdominal aortic diameter suggests that atherosclerosis may not be a causal event in AAA but develops in parallel with or secondary to aneurismal dilatation.
腹主动脉瘤（AAA）形成的发病机制尚不清楚。我们研究了颈动脉、股动脉和冠状动脉粥样硬化与腹主动脉直径之间的关系，以及粥样硬化是否是 AAA 的风险标志物。
对来自一般人群的 6446 名男性和女性进行了右侧颈动脉、股总动脉和腹主动脉的超声检查。动脉粥样硬化的负担评估为颈动脉总斑块面积、股总动脉管腔直径和自述的冠心病。AAA 的定义为最大肾下主动脉直径≥30mm。颈动脉粥样硬化与腹主动脉直径<27mm 之间未发现剂量-反应关系。然而，在主动脉直径≥27mm 和 AAA 中，发现了更多的动脉粥样硬化和冠心病。与无斑块的受试者相比，总斑块面积最高五分位组 AAA 的年龄和性别调整比值比（OR）（95%CI）为 2.3（1.5 至 3.4）。调整后的 OR（95%CI）为 1.7（1.1 至 2.6）。股总动脉管腔直径与 AAA 之间不存在独立的关联。
动脉粥样硬化与腹主动脉直径之间缺乏一致的剂量-反应关系表明，动脉粥样硬化可能不是 AAA 的因果事件，而是与动脉瘤扩张平行或继发发展。
