Faculty of Medicine, University of Porto, Porto, Portugal -
Department of Angiology and Vascular Surgery, Hospital Center of São João, Porto, Portugal.
Int Angiol. 2020 Aug;39(4):330-340. doi: 10.23736/S0392-9590.20.04362-X. Epub 2020 Apr 14.
A paradoxical negative association between diabetes mellitus and abdominal aortic aneurysm (AAA) prevalence and growth is established. However, so far is not possible to determine whether this protection comes from the disease itself or the medication for Diabetes. The aim of this manuscript is to review the association between oral antidiabetic drugs and AAA incidence and growth.
A search was conducted on PubMed and Scopus databases until December 2019 to identify publications reporting on the association between oral antidiabetic drugs (biguanides/metformin, sulfonylureas(SU), thiazolidinediones(TZD), dipeptidyl-peptidase 4(DPP-4) inhibitors, glucagon-like peptide 1(GLP-1) agonists, sodium-glucose transporter protein-2(SGLT2) inhibitors) and the outcomes AAA incidence and growth. Only data from human studies were considered, with a minimum of 3 months follow-up.
Six studies enrolling 25,810 patients were included: one reporting on the AAA risk and five reporting on AAA growth. Metformin prescription was associated with a 28% reduction in AAA occurrence, while SU and TZD were associated with a 18% decrease in AAA risk. Regarding AAA enlargement, results were concordant for a slower expansion rate associated with metformin, with a decrease ranging from -0.30 mm/y to -1.30 mm/y, but not consistent for other antidiabetic drugs.
Metformin seems to be associated with a decrease in AAA risk and enlargement rate. Evidence for the other classes is lacking. Studies evaluating the association between oral antidiabetic drugs and AAA progression, independently of the diabetic status, are needed.
糖尿病与腹主动脉瘤（AAA）的患病率和生长之间存在矛盾的负相关关系已得到证实。然而，目前尚无法确定这种保护是来自于疾病本身还是糖尿病的药物治疗。本文旨在回顾口服降糖药物与 AAA 发生率和生长之间的关系。
在 PubMed 和 Scopus 数据库中进行了搜索，以查找截至 2019 年 12 月报道口服降糖药物（二甲双胍/二甲双胍、磺酰脲类（SU）、噻唑烷二酮类（TZD）、二肽基肽酶 4（DPP-4）抑制剂、胰高血糖素样肽 1（GLP-1）激动剂、钠-葡萄糖协同转运蛋白 2（SGLT2）抑制剂）与 AAA 发生率和生长结局之间关系的出版物。仅考虑了来自人类研究的数据，随访时间至少为 3 个月。
纳入了 6 项共 25810 名患者的研究：1 项报告 AAA 风险，5 项报告 AAA 生长。二甲双胍的处方与 AAA 发生风险降低 28%相关，而 SU 和 TZD 与 AAA 风险降低 18%相关。关于 AAA 扩大，与二甲双胍相关的扩张率较慢的结果是一致的，下降范围从-0.30mm/y 到-1.30mm/y，但其他降糖药物的结果不一致。
二甲双胍似乎与 AAA 风险和扩大率降低相关。其他类别的证据不足。需要评估独立于糖尿病状态的口服降糖药物与 AAA 进展之间的关系的研究。
