Department of Surgery, Section of Coloproctology, Aarhus University Hospital, Aarhus, Denmark.
Elitary Research Centre of Individualised Medicine in Arterial Disease (CIMA), University Hospital Odense, Odense, Denmark; Department of Cardiothoracic and Vascular Surgery, University Hospital Odense, Odense, Denmark.
Eur J Vasc Endovasc Surg. 2017 Dec;54(6):772-777. doi: 10.1016/j.ejvs.2017.10.005. Epub 2017 Oct 31.
The aetiology of abdominal aortic aneurysms (AAA) is multifactorial, and many risk factors are shared with diverticular disease. It is unknown whether an independent association exists between these conditions.
Individuals enrolled in two Danish population based randomised AAA screening trials and assigned to cross sectional screening and evaluation of cardiovascular risk factors were identified. Diagnoses of diverticular disease were interrogated from a national patient registry covering the period from 1977 to the screening date. Adjusted odds ratios (aOR) and hazard ratios (aHR) with 95% CI were calculated as risk measures.
24,632 individuals (median age, 69 years) were included. At screening, 687 patients had pre-existing diverticular disease. Patients with diverticular disease were more likely to have AAA at screening compared with those without diverticular disease (5.2% vs. 3.3%) (OR 1.61, 95% CI 1.14-2.27). This association persisted after adjusting for potential confounders (aOR 1.49, 95% CI 1.04-2.12) and on sensitivity analyses. The association was most pronounced for those with a diagnosis of diverticular disease for at least 10 years (aOR 2.56, 95% CI 1.49-4.38). Following screening, 6.2% of patients with diverticular disease and AAA experienced aneurysm rupture, compared with 2.2% of patients with AAA without diverticular disease (aHR 4.1, 95% CI 1.6-10.8).
An association was found between diverticular disease and AAA in a large population based cohort. Biological causality remains to be established, and a potential impact of diverticular disease on the natural history of AAA needs to be explored further.
腹主动脉瘤（AAA）的病因是多因素的，许多危险因素与憩室病共享。目前尚不清楚这两种疾病之间是否存在独立的关联。
确定参加了两项丹麦基于人群的 AAA 筛查试验并被分配进行横断面筛查和心血管危险因素评估的个体。从一个覆盖从 1977 年到筛查日期的全国患者登记处查询憩室病的诊断。计算了调整后的比值比（OR）和风险比（HR）及其 95%置信区间作为风险指标。
共纳入 24632 名（中位年龄 69 岁）个体。在筛查时，687 名患者患有先前存在的憩室病。与没有憩室病的患者相比，患有憩室病的患者在筛查时更有可能患有 AAA（5.2% vs. 3.3%）（OR 1.61，95%CI 1.14-2.27）。这种关联在调整了潜在混杂因素后仍然存在（aOR 1.49，95%CI 1.04-2.12），并且在敏感性分析中也是如此。对于至少诊断出憩室病 10 年的患者，这种关联最为明显（aOR 2.56，95%CI 1.49-4.38）。在筛查后，6.2%患有憩室病和 AAA 的患者发生了动脉瘤破裂，而没有憩室病的 AAA 患者为 2.2%（aHR 4.1，95%CI 1.6-10.8）。
在一项大型基于人群的队列中发现了憩室病与 AAA 之间的关联。仍然需要确定生物学因果关系，并且需要进一步探讨憩室病对 AAA 自然史的潜在影响。
