Association of abdominal aortic aneurysm diameter with insulin resistance index

Abstract

IntroductionEpidemiological studies have highlighted a negative association between diabetes and abdominal aortic aneurysm (AAA). The aim of this study was to investigate the association between insulin resistance and AAA size.Materials and methodsThis prospective cross sectional monocentric study analysed fasting blood samples from 55 patients with AAA eligible for surgical repair. They were divided into 2 groups according to the median AAA diameter: diameter < 50 mm (N = 28) and diameter > 50 mm (N = 27). The median ages were respectively 73 years (62 - 79) and 72 years (67 - 81). Glucose and fructosamine concentrations were determined by spectrophotometry; insulin and C-peptide using chemiluminescent technology. Homeostasis model assessment 2 calculator was used to estimate insulin resistance index (HOMA2 IR).ResultsThere was no significant difference for fasting glucose concentration between the groups (6.1 vs. 5.9 mmol/L, P = 0.825). C-peptide and insulin concentrations, as well as HOMA2 IR index were significantly higher in patients with AAA > 50 mm (0.82 vs. 0.54 nmol/L, P = 0.012; 9 vs. 5 mU/L, P = 0.019 and 1.72 vs. 1.26, P = 0.028, respectively). No linear correlation was identified between AAA diameter and HOMA2 IR. Fructosamine concentration was lower in patients with AAA > 50 mm (225.5 vs. 251 μmol/L, P = 0.005) and negatively correlated with AAA diameter (r = - 0.54, P < 0.001).ConclusionThis study evidenced an association between AAA diameter and insulin resistance. Further studies are required to determine a causal link between insulin resistance and AAA development.

Diabetes-Induced Changes in Macrophage Biology Might Lead to Reduced Risk for Abdominal Aortic Aneurysm Development

“…An inverse correlation has been reported between fasting blood glucose and glycated haemoglobin A1c (reflecting long-term glucose concentrations) with AAA diameter [7,8]. Moreover, we have demonstrated that serum concentrations of fructosamine, reflecting the glycaemic status over the preceding 2-3-week period, negatively correlated with the AAA diameter [9]. Indeed, using a targeted proteomic approach, we have also published that T2D AAA patients have a distinct plasma inflammatory profile, compared to ND AAA subjects, with a reduced expression of circulating CCL19 and CCL23 chemokines, as well as an increased expression of TNSF14, a member of the TNFα superfamily [10].…”

Translational applications of glucose metabolism in abdominal aortic aneurysm

“…An inverse correlation was observed between fasting blood glucose concentration and AAA diameter (coefficient correlation: -0.0064, p=0.0024) 4 . A negative correlation was also observed between fructosamine concentration, which reflects long-term glucose concentration, and AAA size (coefficient correlation: -0.54, p<0.001) 5 . At last, the level of glycated hemoglobin A1c (HbA1c) was inversely associated with AAA growth rate (coefficient correlation: -0.177, p=0.002) 6 .…”

Insulin Resistance Promotes the Formation of Aortic Dissection by Inducing the Phenotypic Switch of Vascular Smooth Muscle Cells

“…So, in our study, we chose HbA1c as an indicator for evaluating insulin sensitivity. Studies have found that C-peptide, SIC, and HOMA-IR are significantly upregulated in patients with larger aneurysm diameters (20) and that elevated fructosamine and HbA1c levels are high-risk factors for AD (21). One clinical study used HOMA-IR as an indicator of insulin sensitivity, and the results showed that the elasticity of the ascending aorta and its overall properties in IR patients changed with time, with increased stiffness and decreased elastic expansion; this deterioration in those with mild IR was more obvious in a short period of time (34).…”

“…Insulin resistance (IR) accompanies the occurrence and development of type 2 diabetes mellitus (T2DM), which is one of its most important features and is related to atherosclerotic diseases such as coronary artery disease, cerebrovascular disease, carotid artery stenosis, and peripheral vascular disease (19). Studies have shown that C-peptide, serum insulin concentration (SIC), and the homeostasis model assessment of insulin resistance (HOMA-IR) were significantly upregulated in patients with a larger aneurysm diameter (20), and HbA1c was a high-risk factor for AD (21). There have been few studies on the relationship between IR and AD.…”