Increased growth rate of abdominal aortic aneurysms in women, the Tromso Study

Solberg, S.; Singh, K.; Wilsgaard, T.

doi:10.1016/j.jvs.2005.04.008

Cited by 36 publications

(50 citation statements)

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“…Solberg found that over a five year period, the mean growth rate of aneurysms amongst men was 1.82mm/year in contrast to 2.43mm/year in women (Solberg 2005, Mofidi 2007. This is consistent with the finding o f the…”

Section: Gendersupporting

confidence: 85%

The role of the CCR5 Δ32 polymorphism in abdominal aortic aneurysms

Sandford¹,

Bown²,

London³

et al. 2009

Int J Immunogenetics

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All rights reserved INFORMATION TO ALL U SE R S The quality of this reproduction is d ep endent upon the quality of the copy submitted.In the unlikely event that the author did not sen d a com plete manuscript and there are m issing p a g es, th e se will be noted. Also, if material had to be removed, a note will indicate the deletion. Dissertation Publishing UMI U 526187Published by ProQ uest LLC 2013. Copyright in the Dissertation held by the Author. Microform Edition © ProQ uest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States C ode. ProQ uest LLC 789 East Eisenhow er Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 ST A TEM EN T O F O R IG IN A LIT YI hereby declare that the work contained in this thesis is entirely my own, except where acknowledged, and has not been submitted for a degree to this or any other University. R.M.Sandford A B ST R A C T The Role o f the CCR5 A 32 Polymorphism in Abdominal Aortic Aneurysms By R.M.SandfordC-C Chemokine receptor 5 (CCR5) is involved in the regulation o f the inflammatory response. Abdominal aortic aneurysms (AAA) may arise as the result o f a chronic inflammatory process which is influenced by a genetic predisposition. The CCR5 gene harbours a 32 base pair deletion (the A32 polymorphism, rs333). The aim o f this study was to investigate the role o f the CCR5 A32 polymorphism in the development of AAA.A case control study was conducted including 285 patients with AAA and 273 control subjects. A blood sample was taken from each individual and DNA extracted. CCR5 genotype was determined using the polymerase chain reaction (PCR). Flow cytometry was used to investigate the biological activity o f the A32 polymorphism.There was no significant difference between the AAA and the control group in relation to the A32 allele frequency (AAA group 10%, control group 12%, P=0.82, chi squared analysis). There was also no significant difference in CCR5 genotype between groups (wild type homozygotes 82% in AAA group vs 77% in control group, heterozygotes 16% in AAA group vs 21% in control group, and A32 homozygotes 2% in both groups, P=0.33, chi squared analysis). The polymorphism was shown to be biologically active with the number o f A32 alleles correlating with cell expression of CCR5 as detected with flow cytometry (P=<0.05).This study demonstrates that the CCR5 A32 is a biologically active genetic polymorphism, however, there is no association between this polymorphism and AAA. Firstly, to Professor Rob Sayers for allowing me the opportunity to undertake this research and also for his supervision and support throughout the project. P U B L IC A T IO N S A R IS IN G FROM T H IS T H E S ISSandford DM Diabetes Mellitus DNAAlso, to Mr M iff Bown for his friendship, patience and encouragement in addition to providing statistical and scientific support. Demographic data 103 Table 7.2: Patient and control subject co-morbidity 105 Table 7.3: Patient and control group medication 106 Table 7.4: Univariate analysis of demog...

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Section: Gendersupporting

confidence: 85%

The role of the CCR5 Δ32 polymorphism in abdominal aortic aneurysms

Sandford¹,

Bown²,

London³

et al. 2009

Int J Immunogenetics

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“…22 Although a single small study suggested that female gender was an independent predictor of growth rate, the magnitude of the difference was only 0.7 mm per annum. 23 For a given diameter, the time to rupture is less in women than in men. 24 In the UK Small Aneurysm Trial, the risk of rupture in women was 4-fold that of men (hazard ratio, 4.0; 95% CI, 2.0 to 7.9).…”

mentioning

confidence: 99%

Abdominal Aortic Aneurysm

2007

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M ost manifestations of cardiovascular disease are more common in men than in women. However, cardiovascular disease is the most common cause of death in women worldwide. 1 Coronary heart disease in women has a worse outcome than in men, and this has attracted considerable attention in recent years, with calls for more gender-specific research. 1,2 Abdominal aortic aneurysms (AAAs) also are less common in women than in men, and, as with coronary heart disease, there is evidence that women with AAA also have a worse prognosis. The present review addresses the epidemiology, development, natural history, management, and outcomes of AAA in women. Prevalence and IncidenceWhen the definition of a maximum external diameter Ն3 cm is used, the prevalence of AAA is up to 6 times greater in men than in women. 3,4 In a community-based screening study of the older population, the prevalence of AAA was 1.3% in women compared with 7.6% in men. 4 Similarly, the ratio of men to women in surgical series is Ϸ5:1. 5-7 Because of the relatively low prevalence, women were excluded from the large trials of screening for AAA. 8 -10 The prevalence in women from families with a strong history of AAA may be as high as 8.3%, and these women should be offered screening. 11 Modeling studies have indicated that screening for AAA in women could be cost-effective because the rupture rate appears to be much higher in women than in men. 12 The incidence of AAA has continued to rise over the last 4 decades. [13][14][15][16] Initially, a similar pattern was seen in both genders, although the increase in mortality and admission rate has been become more marked in women. 15,16 Inspection of data derived from national (England and Wales) statistics shows that the annual number of hospital admissions for aneurysm rupture between 1997 and 2005 has declined by 2% to 3% per annum in men. 17 In women, although the total number of admissions for ruptured AAA is Ϸ40% of male admissions, there has been an increase of Ϸ0.5% per annum since 2005. The reasons for this are unknown. Population screening for AAA in men is not yet widespread in England and Wales and is unlikely to have made a major contribution to these trends. However, AAA appears to be a late event after smoking exposure, and these trends may reflect temporal changes in smoking prevalence. The rise of smoking in women occurred over the period 1950 to 1970, several decades after the widespread uptake of smoking by men. Since then, rates of cessation have been greater in men than in women. 18 The presence of an AAA is associated with aneurysms of the iliac, femoral, and popliteal arteries, but, compared with AAA, all of these have a higher incidence ratio in men versus women. 19 However, some aneurysms are found predominantly or equally in women, with splenic 20 and cerebral artery 21 aneurysms being respective examples. Natural History: Expansion and RuptureThere is no good evidence to suggest that aneurysm growth rate is different in men and women. 22 Although a single small study suggested that ...

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“…Scott and colleagues conducted the only RCT (Chichester trial) which studied the value of screening in women over the age of 65 in an unselected population (n=9342) 21 . They reported the prevalence of AAA in women to be 1·3 percent, with other authors reporting a similar rate of 0·7-1·3 percent in unselected populations [22][23][24] . Scott et al did not demonstrate a difference in rupture rates between the women randomized to screening and control populations of women at 5-and 10-year follow-up 21 .…”

Section: Targeted Screening For Aaamentioning

confidence: 72%