A contemporary meta-analysis of the association of diabetes with abdominal aortic aneurysm.

AIM

Aim of the present study was to determine whether diabetes is independently and inversely associated with prevalence of abdominal aortic aneurysm (AAA). We performed a meta-analysis of contemporary literature in which adjusted (but not unadjusted) relative risk estimates are available.

METHODS

MEDLINE and EMBASE were searched from January 1999 to April 2014 using Web-based search engines (PubMed and OVID). Studies considered for inclusion met the following criteria: the design was a prospective-cohort, population-screening, or case-control study; the study population was individuals with and without diabetes or AAA; and outcomes included adjusted (but not unadjusted) relative risks for prevalence/incidence of AAA in patients with diabetes versus subjects without diabetes. Study-specific adjusted relative risk estimate were combined using inverse variance-weighted average of logarithmic odds ratios (or hazard ratios) in the random-effects model.

RESULTS

Of 324 potentially relevant articles screened initially, 13 eligible studies were identified and included. A pooled analysis of all the 13 studies demonstrated that diabetes was significantly associated with lower prevalence of AAA (odds ratio, 0.59; 95% confidence interval, 0.52 to 0.67; P<0.00001). When data from 6 prospective-cohort, 5 population-screening, and 2 case-control studies were separately pooled, diabetes was also significantly associated with lower prevalence of AAA (P for subgroup differences =0.05).

CONCLUSION

Diabetes appears to be inversely associated with prevalence of AAA.