Pafili Kalliopi, Gouni-Berthold Ioanna, Papanas Nikolaos, Mikhailidis Dimitri P
Diabetes Clinic, Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Center for Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Cologne, Germany.
J Diabetes Complications. 2015 Nov-Dec;29(8):1330-6. doi: 10.1016/j.jdiacomp.2015.08.011. Epub 2015 Aug 20.
There is accumulating evidence that risk profiles differ between coronary artery disease and abdominal aortic aneurysms (AAAs). However, diabetes mellitus (DM) appears to be negatively associated with AAA formation. The underlying mechanisms for this negative relationship are far from defined, but may include: increased arterial wall matrix formation via advanced glycation end products; suppression of plasmin and reduction of levels and activity of matrix metalloproteinases (MMP)-2 and 9; diminished aortic wall macrophage infiltration, elastolysis and neovascularization. In addition, the effect of pharmacological agents used for the treatment of patients with DM on AAA formation has been studied with rather controversial results. Statins, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, fenofibrate, antibiotics and some hypoglycemic agents are beginning to be appreciated for a potential modest protection from AAAs, but further studies are needed.
越来越多的证据表明，冠状动脉疾病和腹主动脉瘤（AAA）的风险特征有所不同。然而，糖尿病（DM）似乎与AAA的形成呈负相关。这种负相关的潜在机制远未明确，但可能包括：通过晚期糖基化终产物增加动脉壁基质形成；抑制纤溶酶以及降低基质金属蛋白酶（MMP）-2和9的水平及活性；减少主动脉壁巨噬细胞浸润、弹性蛋白溶解和新生血管形成。此外，用于治疗DM患者的药物制剂对AAA形成的影响已有研究，但结果颇具争议。他汀类药物、血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂、非诺贝特、抗生素和一些降糖药物开始被认为可能对AAA有一定程度的保护作用，但仍需进一步研究。
