糖尿病相关因素与腹主动脉瘤事件：社区动脉粥样硬化风险研究。
Diabetes-related factors and abdominal aortic aneurysm events: the Atherosclerotic Risk in Communities Study.
机构信息
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis.
出版信息
Ann Epidemiol. 2018 Feb;28(2):102-106.e1. doi: 10.1016/j.annepidem.2017.12.003. Epub 2017 Dec 16.
PURPOSE
To test the hypothesis that diabetes-related factors (metabolic syndrome [MetS], glucose, insulin, and leptin) are inversely associated with abdominal aortic aneurysm (AAA) risk.
METHODS
We followed 13,736 participants, aged 45-64 years, without prior AAA surgery at baseline (1987-1989), for AAA occurrence through 2011. Hazard ratios (HRs) and their 95% confidence intervals (CIs) of AAA were calculated using Cox regression.
RESULTS
During 275,054 person-years of follow-up, we identified 518 AAA events. Fasting serum glucose was associated inversely with AAA risk (HR [95% CI] per one unit increment in log(glucose), 0.54 [0.36-0.80]), but fasting insulin was not associated with AAA. Plasma leptin was also associated inversely with AAA occurrence (HR [95% CI] per one unit increment in log(leptin), 0.83 [0.71-0.98]). Compared with individuals without MetS, those with MetS had increased risk of AAA (HR [95% CI], 1.24 [1.04-1.48]). Among individuals with or without diabetes, the HRs increased monotonically with a greater number of non-glucose MetS components.
CONCLUSIONS
Diabetes, fasting glucose, and plasma leptin were inversely associated with risk of AAA. In contrast, the MetS was associated with increased risk of AAA, due to the influence of the non-glucose MetS components.
目的
检验糖尿病相关因素（代谢综合征[MetS]、血糖、胰岛素和瘦素）与腹主动脉瘤（AAA）风险呈负相关的假设。
方法
我们对 13736 名年龄在 45-64 岁、基线时无 AAA 手术史的参与者进行了随访，随访时间从 1987 年至 1989 年，以观察 2011 年之前 AAA 的发生情况。使用 Cox 回归计算 AAA 的风险比（HR）及其 95%置信区间（CI）。
结果
在 275054 人年的随访期间，我们共发现了 518 例 AAA 事件。空腹血糖与 AAA 风险呈负相关（每增加一个单位的 log（血糖），HR[95%CI]为 0.54[0.36-0.80]），但空腹胰岛素与 AAA 无关。血浆瘦素也与 AAA 的发生呈负相关（每增加一个单位的 log（瘦素），HR[95%CI]为 0.83[0.71-0.98]）。与没有 MetS 的个体相比，患有 MetS 的个体 AAA 发病风险增加（HR[95%CI]为 1.24[1.04-1.48]）。在有或没有糖尿病的个体中，HR 随着非血糖 MetS 成分数量的增加而呈单调递增趋势。
结论
糖尿病、空腹血糖和血浆瘦素与 AAA 的发病风险呈负相关。相比之下，代谢综合征与 AAA 风险的增加有关，这是由于非血糖 MetS 成分的影响。
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