Zhang Simeng, Liu Jie, Jia Xin, Zhang Tao, Qin Xianhui, Jia Senhao, Li Yue, Liu Lishun, Song Yuxiang, Zuo Shangwei, Wei Ren, Duan Chen, Wu Zhongyin, Ge Yangyang, Wang Xian, Kong Wei, Xu Xiping, Wang Qiang, Huo Yong, Guo Wei
Department of Pediatric Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China.
Ann Transl Med. 2022 Apr;10(7):419. doi: 10.21037/atm-22-1256.
There is epidemiological evidence that diabetes has a protective effect on the occurrence and development of abdominal aortic aneurysms (AAAs). However, information on the role of glucose level on abdominal aortic diameter is limited. This study sought to assess the relationship between fasting plasma glucose (FPG) and infra-renal aortic diameter in a Chinese hypertensive population.
The prospective participants comprised candidates from 2 large population-based studies on the clinical presentation and management of hypertension in China. In total, 18,034 hypertensive participants (6,942 male and 11,092 females, with a mean age of 64.72±7.41 years) were included in the study. The maximal diameter of the infra-renal aorta was measured by ultrasound scanning. Multivariate linear regression analyses were conducted to assess the specific association between FPG and abdominal aortic diameter. The interaction terms between the baseline covariables and the aortic diameter were used to determine if a variable affected the association between FPG and abdominal aortic diameter.
Of these, 22 cases of AAA were identified, and the prevalence of diabetes was lower in those with AAA than those without. A significant negative association was also found between FPG and aortic diameter in both sexes. A dose-dependent decrease in the prevalence of diabetes across quartiles of aortic diameter was also observed, with an estimated odds ratio (OR) of 0.60 (95% CI: 0.50-0.72) for men and 0.72 (95% CI: 0.63-0.82) for women for the top quartiles compared to the bottom quartiles. Cigarette smoking only interacted with the association between FPG level and aortic diameter in women. The association did not differ with other subgroups.
Our findings indicate that glycaemia may plays a protective role in the early stage of aortic dilatation in both sexes in a Chinese hypertensive population. Prospective studies need to be conducted to confirm our findings and explore the mechanism underlying this association in different populations.
有流行病学证据表明，糖尿病对腹主动脉瘤（AAA）的发生和发展具有保护作用。然而，关于血糖水平对腹主动脉直径作用的信息有限。本研究旨在评估中国高血压人群中空腹血糖（FPG）与肾下腹主动脉直径之间的关系。
前瞻性参与者包括来自两项关于中国高血压临床表现和管理的大型人群研究的受试者。本研究共纳入18034名高血压参与者（男性6942名，女性11092名，平均年龄64.72±7.41岁）。通过超声扫描测量肾下腹主动脉的最大直径。进行多变量线性回归分析以评估FPG与腹主动脉直径之间的具体关联。基线协变量与主动脉直径之间的交互项用于确定一个变量是否影响FPG与腹主动脉直径之间的关联。
其中，确诊22例AAA，AAA患者的糖尿病患病率低于无AAA患者。在男性和女性中，FPG与主动脉直径之间均存在显著的负相关。在主动脉直径四分位数范围内，糖尿病患病率也呈剂量依赖性下降，与最低四分位数相比，最高四分位数男性的估计比值比（OR）为0.60（95%CI：O.50 - 0.72），女性为0.72（95%CI：0.63 - 0.82）。仅吸烟与女性FPG水平和主动脉直径之间的关联存在交互作用。该关联在其他亚组中无差异。
我们的研究结果表明，在中国高血压人群中，血糖水平可能在两性主动脉扩张的早期阶段发挥保护作用。需要进行前瞻性研究以证实我们的发现，并探索不同人群中这种关联的潜在机制。
