Advanced complicated diabetes mellitus is associated with a reduced risk of thoracic and abdominal aortic aneurysm rupture: a population‐based cohort study

Tsai, Chuen-Tinn; Lin, Cheng‐Li; Wu, Yi-Ying; Shieh, Dong-Chen; Sung, Fung‐Chang; Kao, Chia‐Hung

doi:10.1002/dmrr.2585

Cited by 53 publications

(72 citation statements)

References 49 publications

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“…Of 100 potentially relevant articles screened initially, nine eligible studies 8,[11][12][13][14][15][16][17][18] were identified. Furthermore, two relevant studies 6,7 were added through a manual search.…”

Section: Resultsmentioning

confidence: 99%

“…In total, our meta-analysis included 11 studies. [6][7][8][11][12][13][14][15][16][17][18] Study design (Table 1), patient characteristics (Table 1; online Appendices 1 and 2), diabetes prevalence, rupture incidence and relative risk of rupture are summarized in Table 2. In a case-control study by Buijs et al, 11 non-ruptured symptomatic AAA and ruptured AAA were combined and labelled as non-elective AAA.…”

Section: Resultsmentioning

confidence: 99%

“…In the rupture group of another case-control study by Fillinger et al, 13 emergency AAA repair was performed because of rupture or acute severe pain. As a primary meta-analysis, thus, we combined the remaining nine studies [6][7][8]12,[14][15][16][17][18] reporting data on ruptured (not including non-ruptured symptomatic) AAA. Additionally, all of the 11 studies were combined as a secondary meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…significantly lower AAA-rupture prevalence in diabetes), which was sequentially eliminated in sensitivity analyses to assess their impact on the pooled effect estimate. The primary meta-analysis of the nine studies [6][7][8]12,[14][15][16][17][18] demonstrated that diabetes was associated with significantly lower prevalence/incidence of AAA rupture (i.e. significantly and negatively associated with AAA rupture) (fixed-effects OR/HR, 0.71; 95% CI, 0.56 to 0.89; p = 0.003; Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…There was no evidence of significant publication bias (two-tailed p with continuity correction = 1.00 by the adjusted rank-correlation test; 9 two-tailed p = 0.60 by the linear regression test 10 ). Tsai et al 18 Retrospective population- …”

Section: Resultsmentioning

confidence: 99%

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Negative association of diabetes with rupture of abdominal aortic aneurysm

Takagi

Umemoto

2016

Diabetes and Vascular Disease Research

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Purpose: To summarize the association of diabetes with abdominal aortic aneurysm rupture, we reviewed currently available studies with a systematic literature search and meta-analytic evaluation. Methods: To identify all studies reporting the association of diabetes with abdominal aortic aneurysm rupture, MEDLINE and EMBASE were searched through July 2015. For each study, data regarding diabetes prevalence in both the ruptured and non-ruptured groups were used to generate an unadjusted odds ratio for abdominal aortic aneurysm rupture and 95% confidence intervals. Alternatively, an unadjusted or adjusted odds ratio, or hazard ratio for abdominal aortic aneurysm rupture with 95% confidence interval was directly abstracted (as available) from each individual study. Results: Our search identified 11 eligible studies. A primary meta-analysis of nine studies reporting data on ruptured (not including non-ruptured symptomatic) abdominal aortic aneurysm demonstrated that diabetes was associated with significantly lower prevalence/incidence of abdominal aortic aneurysm rupture (odds ratio/hazard ratio, 0.71; 95% confidence interval, 0.56 to 0.89; p = 0.003). A secondary meta-analysis of all 11 studies (adding two studies in which nonruptured symptomatic abdominal aortic aneurysm was included in the rupture group) also demonstrated that diabetes was associated with significantly lower prevalence/incidence of abdominal aortic aneurysm rupture (odds ratio/hazard ratio, 0.77; 95% confidence interval, 0.63 to 0.95; p = 0.01). Conclusion: Diabetes is negatively associated with abdominal aortic aneurysm rupture.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Negative association of diabetes with rupture of abdominal aortic aneurysm

Takagi

Umemoto

2016

Diabetes and Vascular Disease Research

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Blood pressure, hypertension and the risk of abdominal aortic aneurysms: a systematic review and meta-analysis of cohort studies

et al. 2019

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Abdominal aortic aneurysms (AAA) are fatal in 80% of the cases when ruptured. Hypertension has been considered a potential risk factor for AAA; but the findings from prospective cohort studies have not been entirely consistent, nor have they been summarised in a comprehensive meta-analysis. Our aim was to conduct a systematic review and meta-analysis of cohort studies of the association between blood pressure, hypertension and AAA to clarify the strength and shape of these associations. We searched PubMed and Embase databases for relevant cohort studies up to April 30th, 2018. Random-effects models were used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs). The meta-analysis included 21 cohort studies (20 publications) with data on 28,162 cases and 5,440,588 participants. The findings indicate that the RR of AAA in hypertensive patients is 1.66 times (95% CI: 1.49–1.85, I 2 = 79.3%, n = 13) that of non-hypertensive patients. In addition, there was a 14% (95% CI: 6–23%, I 2 = 30.5%, n = 6) and a 28% (95% CI: 12–46%, I 2 = 80.1%, n = 6) increase in the RR of AAA for every 20 mmHg and 10 mmHg increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively. The analysis of DBP showed evidence of a strong and highly significant nonlinear dose–response relationship ( p < 0.001) with a steeper association from 80 mmHg and above. This meta-analysis suggests that hypertension increases the risk of developing AAA by 66%. Further studies are needed to clarify the underlying mechanism explaining the much stronger association between DBP and AAA than for SBP. Electronic supplementary material The online version of this article (10.1007/s10654-019-00510-9) contains supplementary material, which is available to authorized users.

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