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二甲双胍治疗与糖尿病患者升主动脉瘤患病率较低无关。

Metformin therapy is not associated with the lower prevalence of ascending aortic aneurysm in diabetic patients.

作者信息

Vignac Maxime, Ntika Stelia, Olsson Christian, Franco-Cereceda Anders, Björck Hanna M

机构信息

Cardiovascular Medicine Unit, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Karolinska University Hospital, Solna, Sweden.

Karolinska University Hospital, Solna, Sweden.

出版信息

Eur J Cardiothorac Surg. 2022 Jan 24;61(2):388-392. doi: 10.1093/ejcts/ezab435.

Abstract

OBJECTIVES

Metformin therapy has previously been associated with reduced abdominal aortic aneurysm growth rate in diabetic patients and shown to suppress the formation and progression of abdominal aortic aneurysm in normoglycemic mice. Here, we investigated the association between Metformin treatment and prevalence of aneurysm in the ascending aorta (AscAA).

METHODS

A total of 734 patients undergoing open-heart surgery for AscAA and/or aortic valve disease were studied. Diabetes status and medication use were self-reported by the patients in a systematic questionnaire. Aortic dilatation was defined as an aortic root or ascending aortic diameter ≥4.0 cm. High-sensitivity C-reactive protein levels were assessed as a measure of systemic inflammation.

RESULTS

We could confirm the inverse association between diabetes and AscAA prevalence (16% vs 43.9%, for diabetic and non-diabetic patients, respectively; Odds ratio 0.243; 95% CI, 0.129-0.460, P < 0.001). Furthermore, in diabetic patients, Metformin treatment was associated with lower high-sensitivity C-reactive protein levels. There was, however, no difference in the prevalence of AscAA among diabetic patients with and without Metformin treatment (16% vs 16% for treated and non-treated patients, respectively; OR 1.039; 95% CI 0.26-4.19, P = 0.957).

CONCLUSIONS

Our data do not support a protective effect of Metformin therapy in AscAA formation.

SUBJ COLLECTION

161, 173.

摘要

目的

二甲双胍治疗先前已被证明与糖尿病患者腹主动脉瘤生长速率降低有关,并显示可抑制血糖正常小鼠腹主动脉瘤的形成和进展。在此,我们研究了二甲双胍治疗与升主动脉瘤(AscAA)患病率之间的关联。

方法

共研究了734例因升主动脉瘤和/或主动脉瓣疾病接受心脏直视手术的患者。患者通过系统问卷自行报告糖尿病状态和用药情况。主动脉扩张定义为主动脉根部或升主动脉直径≥4.0 cm。评估高敏C反应蛋白水平作为全身炎症的指标。

结果

我们可以确认糖尿病与升主动脉瘤患病率之间存在负相关(糖尿病患者和非糖尿病患者分别为16%和43.9%;比值比0.243;95%可信区间,0.129 - 0.460,P < 0.001)。此外,在糖尿病患者中,二甲双胍治疗与较低的高敏C反应蛋白水平相关。然而,接受和未接受二甲双胍治疗的糖尿病患者中升主动脉瘤患病率没有差异(治疗组和未治疗组患者分别为16%和16%;OR 1.039;95%可信区间0.26 - 4.19,P = 0.957)。

结论

我们的数据不支持二甲双胍治疗对升主动脉瘤形成有保护作用。

主题分类

161, 173。

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