Takagi Hisato, Umemoto Takuya
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shimizu, Japan
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shimizu, Japan.
Angiology. 2016 Jul;67(6):513-25. doi: 10.1177/0003319715602414. Epub 2015 Aug 25.
We performed a systematic literature search and a meta-analysis to assess the association between diabetes mellitus (DM) and abdominal aortic aneurysm (AAA) growth. Databases including MEDLINE and EMBASE were searched through June 2015 using PubMed and OVID. For each study, data regarding AAA growth rates in both the DM and the non-DM groups were used to generate standardized mean differences (SMDs) and 95% confidence intervals (CIs). Our search identified 19 relevant studies including data on 9777 patients with AAA. Pooled analyses demonstrated a statistically significant slower growth rates in DM patients than in non-DM patients (unadjusted SMD, -0.32; 95% CI, -0.40 to -0.24; P < .00001; adjusted SMD, -0.29; 95% CI, -0.417 to -0.18; P < .00001). Despite possible publication bias in favor of DM based on funnel plot asymmetry, even adjustment of the asymmetry did not alter the beneficial effect of DM. In conclusion, on the basis of a meta-analysis of data on a total of 9777 patients (19 studies) identified through a systematic literature search, we confirmed the association of DM with slower growth rates of AAA.
我们进行了一项系统的文献检索和荟萃分析，以评估糖尿病（DM）与腹主动脉瘤（AAA）生长之间的关联。通过PubMed和OVID检索了包括MEDLINE和EMBASE在内的数据库，检索截止至2015年6月。对于每项研究，使用糖尿病组和非糖尿病组中AAA生长率的数据来生成标准化平均差（SMD）和95%置信区间（CI）。我们的检索共识别出19项相关研究，纳入了9777例AAA患者的数据。汇总分析显示，糖尿病患者的生长速度在统计学上显著慢于非糖尿病患者（未调整的SMD为-0.32；95%CI为-0.40至-0.24；P<0.00001；调整后的SMD为-0.29；95%CI为-0.417至-0.18；P<0.00001）。尽管基于漏斗图不对称性可能存在有利于糖尿病的发表偏倚，但即使对不对称性进行调整也不会改变糖尿病的有益作用。总之，基于对通过系统文献检索识别出的总共9777例患者（19项研究）的数据进行的荟萃分析，我们证实了糖尿病与AAA生长速度较慢之间的关联。
