Picatoste Belén, Cerro-Pardo Isabel, Blanco-Colio Luis M, Martín-Ventura Jose L
Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
Biomedicine Department, Alfonso X El Sabio University, Madrid, Spain.
Front Cardiovasc Med. 2023 Mar 23;10:1112430. doi: 10.3389/fcvm.2023.1112430. eCollection 2023.
Aortic aneurysms, including abdominal aortic aneurysms (AAAs), is the second most prevalent aortic disease and represents an important cause of death worldwide. AAA is a permanent dilation of the aorta on its infrarenal portion, pathologically associated with oxidative stress, proteolysis, vascular smooth muscle cell loss, immune-inflammation, and extracellular matrix remodeling and degradation. Most epidemiological studies have shown a potential protective role of diabetes mellitus (DM) on the prevalence and incidence of AAA. The effect of DM on AAA might be explained mainly by two factors: hyperglycemia [or other DM-related factors such as insulin resistance (IR)] and/or by the effect of prescribed DM drugs, which may have a direct or indirect effect on the formation and progression of AAAs. However, recent studies further support that the protective role of DM in AAA may be attributable to antidiabetic therapies (i.e.: metformin or SGLT-2 inhibitors). This review summarizes current literature on the relationship between DM and the incidence, progression, and rupture of AAAs, and discusses the potential cellular and molecular pathways that may be involved in its vascular effects. Besides, we provide a summary of current antidiabetic therapies which use could be beneficial for AAA.
主动脉瘤，包括腹主动脉瘤（AAA），是第二常见的主动脉疾病，也是全球范围内一个重要的死亡原因。腹主动脉瘤是主动脉肾下部分的永久性扩张，病理上与氧化应激、蛋白水解、血管平滑肌细胞丢失、免疫炎症以及细胞外基质重塑和降解相关。大多数流行病学研究表明，糖尿病（DM）对腹主动脉瘤的患病率和发病率具有潜在的保护作用。糖尿病对腹主动脉瘤的影响可能主要由两个因素来解释：高血糖[或其他与糖尿病相关的因素，如胰岛素抵抗（IR）]和/或所使用的糖尿病药物的作用，这些药物可能对腹主动脉瘤的形成和进展有直接或间接影响。然而，最近的研究进一步支持，糖尿病在腹主动脉瘤中的保护作用可能归因于抗糖尿病治疗（即：二甲双胍或钠-葡萄糖协同转运蛋白2抑制剂）。本综述总结了关于糖尿病与腹主动脉瘤的发病率、进展和破裂之间关系的当前文献，并讨论了可能涉及其血管效应的潜在细胞和分子途径。此外，我们总结了目前使用可能对腹主动脉瘤有益的抗糖尿病治疗方法。
