Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
J Diabetes Complications. 2018 Dec;32(12):1169-1174. doi: 10.1016/j.jdiacomp.2018.09.009. Epub 2018 Sep 15.
Diabetes mellitus has been associated with reduced risk of abdominal aortic aneurysm in a number of epidemiological studies, however, until recently little data from prospective studies have been available. We therefore conducted a systematic review and meta-analysis of prospective studies to quantify the association.
Two investigators searched the PubMed and Embase databases for studies of diabetes and abdominal aortic aneurysm up to May 8th 2018. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (95% CIs) of abdominal aortic aneurysm associated with a diabetes diagnosis. Summary relative risks were estimated by use of a random effects model.
We identified 16 prospective studies with 16,572 cases among 4,563,415 participants that could be included in the meta-analysis. The summary RR for individuals with diabetes compared to individuals without diabetes was 0.58 (95% CI: 0.51-0.66, I = 40.4%, p = 0.06). The results persisted when stratified by sex, duration of follow-up, and in most of the other subgroup analyses. There was no evidence of publication bias with Egger's test, p = 0.64 or by inspection of the funnel plots.
These results suggest that individuals with diabetes mellitus are at a reduced risk of abdominal aortic aneurysm, however, whether pharmacological agents for diabetes mellitus explain this observation needs to be clarified in future studies.
多项流行病学研究表明，糖尿病与腹主动脉瘤风险降低相关，但截至目前，仅有少量前瞻性研究的数据可用。因此，我们进行了系统评价和荟萃分析，以量化这种相关性。
两名调查员于 2018 年 5 月 8 日前在 PubMed 和 Embase 数据库中搜索了关于糖尿病与腹主动脉瘤的研究。前瞻性研究如果报告了与糖尿病诊断相关的腹主动脉瘤的调整后相对风险（RR）估计值及其 95%置信区间（95%CI），则被纳入荟萃分析。使用随机效应模型估计汇总 RR。
我们确定了 16 项前瞻性研究，这些研究纳入了 4563415 名参与者中的 16572 例腹主动脉瘤病例，可以纳入荟萃分析。与无糖尿病的个体相比，患有糖尿病的个体的 RR 为 0.58（95%CI：0.51-0.66，I=40.4%，p=0.06）。当按性别、随访时间和大多数其他亚组分析进行分层时，结果仍然成立。Egger 检验（p=0.64）或漏斗图检查均未发现发表偏倚的证据。
这些结果表明，患有糖尿病的个体患腹主动脉瘤的风险降低，但需要在未来的研究中阐明是否糖尿病的药物治疗可以解释这一观察结果。
