Department of Surgical Sciences, University of Otago, Dunedin, New Zealand.
Department of Funding and Planning, Auckland & Waitemata District Health Boards, New Zealand.
Eur J Vasc Endovasc Surg. 2019 Feb;57(2):221-228. doi: 10.1016/j.ejvs.2018.08.048. Epub 2018 Oct 4.
Recently, the prevalence of abdominal aortic aneurysm (AAA) using screening strategies based on elevated cardiovascular disease (CVD) risk was reported. AAA was defined as a diameter ≥30 mm, with prevalence of 6.1% and 1.8% in men and women respectively, consistent with the widely reported AAA predominant prevalence in males. Given the obvious differences in body size between sexes this study aimed to re-evaluate the expanded CVD risk based AAA screening dataset to determine the effect of body size on sex specific AAA prevalence.
Absolute (26 and 30 mm) and relative (aortic size index [ASI] equals the maximum infrarenal aorta diameter (cm) divided by body surface area (m), ASI ≥ 1.5) thresholds were used to assess targeted AAA screening groups (n = 4115) and compared with a self reported healthy elderly control group (n = 800).
Male AAA prevalence was the same using either the 30 mm or ASI ≥1.5 aneurysm definitions (5.7%). In females, AAA prevalence was significantly different between the 30 mm (2.4%) and ASI ≥ 1.5 (4.5%) or the 26 mm (4.4%) thresholds.
The results suggest the purported male predominance in AAA prevalence is primarily an artefact of body size differences. When aortic size is adjusted for body surface area there is only a modest sex difference in AAA prevalence. This observation has potential implications in the context of the ongoing discussion regarding AAA screening in women.
最近，基于心血管疾病（CVD）风险升高的筛查策略报告了腹主动脉瘤（AAA）的流行率。AAA 的定义为直径≥30mm，男性和女性的患病率分别为 6.1%和 1.8%，与男性中广泛报道的 AAA 主要患病率一致。鉴于性别之间的体型差异明显，本研究旨在重新评估基于 CVD 风险扩大的 AAA 筛查数据集，以确定体型对性别特异性 AAA 患病率的影响。
使用绝对（26 和 30mm）和相对（主动脉大小指数[ASI]等于下腔主动脉最大直径（cm）除以体表面积（m），ASI≥1.5）阈值来评估靶向 AAA 筛查组（n=4115），并与自我报告的健康老年对照组（n=800）进行比较。
使用 30mm 或 ASI≥1.5 定义的男性 AAA 患病率相同（5.7%）。在女性中，30mm（2.4%）和 ASI≥1.5（4.5%）或 26mm（4.4%）阈值之间的 AAA 患病率存在显著差异。
结果表明，AAA 患病率中所谓的男性优势主要是体型差异的人为因素。当主动脉大小根据体表面积进行调整时，AAA 患病率只有适度的性别差异。这一观察结果在关于女性 AAA 筛查的持续讨论中具有潜在意义。
