TY - JOUR
T1 - Glycated Hemoglobin Is Associated With the Growth Rate of Abdominal Aortic Aneurysms
T2 - A Substudy From the VIVA (Viborg Vascular) Randomized Screening Trial
AU - Kristensen, Katrine Lawaetz
AU - Dahl, Marie
AU - Rasmussen, Lars Melholt
AU - Lindholt, Jes Sanddal
PY - 2017/4
Y1 - 2017/4
N2 - OBJECTIVE—: An inverse association between abdominal aortic aneurysms (AAAs) and diabetes mellitus exists; however, the cause remains unknown. This study aimed to evaluate whether the degree of glycemia is associated with aneurysm growth. APPROACH AND RESULTS—: The study was based on VIVA trial (Viborg Vascular), the randomized clinically controlled screening trial for abdominal aortic aneurysm in men aged 65 to 74 years in the Central Denmark Region. The screening included measurement of the abdominal aorta by ultrasound, analysis of glycated hemoglobin (HbA1c), and follow-up for ≤5 years for aneurysms <5 cm. Analyses were conducted using mixed-effect models. At baseline, VIVA screening identified 619 individuals (3.3%) with abdominal aortic aneurysms. A total of 103 individuals were referred for vascular evaluation, and after removal of additional individuals who were lost to follow-up or had missing blood samples, we were left with 319 individuals. Sixty-one individuals (19.1%) had diabetes mellitus. The median growth rate was 1.7 versus 2.7 mm/y in individuals with and without diabetes mellitus, respectively (P<0.001). We found a significant inverse association between aneurysmal growth rate and HbA1c in the total study population (P=0.002). Both crude and adjusted analyses identified slower growth for the group with the highest HbA1c tertile compared with the lowest HbA1c tertile. After 3 years, the mean difference was 1.8 mm (confidence interval, 0.98–2.64). Similar significant differences were observed in subgroup analysis of individuals without self-reported diabetes mellitus. CONCLUSIONS—: We found an inverse association between the growth rate of abdominal aortic aneurysms and the level of HbA1c, indicating that long-lasting elevated blood sugar impairs aneurysmal progression in individuals with and without known diabetes mellitus.
AB - OBJECTIVE—: An inverse association between abdominal aortic aneurysms (AAAs) and diabetes mellitus exists; however, the cause remains unknown. This study aimed to evaluate whether the degree of glycemia is associated with aneurysm growth. APPROACH AND RESULTS—: The study was based on VIVA trial (Viborg Vascular), the randomized clinically controlled screening trial for abdominal aortic aneurysm in men aged 65 to 74 years in the Central Denmark Region. The screening included measurement of the abdominal aorta by ultrasound, analysis of glycated hemoglobin (HbA1c), and follow-up for ≤5 years for aneurysms <5 cm. Analyses were conducted using mixed-effect models. At baseline, VIVA screening identified 619 individuals (3.3%) with abdominal aortic aneurysms. A total of 103 individuals were referred for vascular evaluation, and after removal of additional individuals who were lost to follow-up or had missing blood samples, we were left with 319 individuals. Sixty-one individuals (19.1%) had diabetes mellitus. The median growth rate was 1.7 versus 2.7 mm/y in individuals with and without diabetes mellitus, respectively (P<0.001). We found a significant inverse association between aneurysmal growth rate and HbA1c in the total study population (P=0.002). Both crude and adjusted analyses identified slower growth for the group with the highest HbA1c tertile compared with the lowest HbA1c tertile. After 3 years, the mean difference was 1.8 mm (confidence interval, 0.98–2.64). Similar significant differences were observed in subgroup analysis of individuals without self-reported diabetes mellitus. CONCLUSIONS—: We found an inverse association between the growth rate of abdominal aortic aneurysms and the level of HbA1c, indicating that long-lasting elevated blood sugar impairs aneurysmal progression in individuals with and without known diabetes mellitus.
KW - Aged
KW - Aortic Aneurysm, Abdominal/blood
KW - Biomarkers/blood
KW - Comorbidity
KW - Denmark/epidemiology
KW - Diabetes Mellitus/blood
KW - Disease Progression
KW - Glycated Hemoglobin A/analysis
KW - Humans
KW - Male
KW - Mass Screening/methods
KW - Predictive Value of Tests
KW - Prevalence
KW - Protective Factors
KW - Risk Factors
KW - Time Factors
KW - Ultrasonography
U2 - 10.1161/ATVBAHA.116.308874
DO - 10.1161/ATVBAHA.116.308874
M3 - Journal article
C2 - 28183702
AN - SCOPUS:85012168810
SN - 1079-5642
VL - 37
SP - 730
EP - 736
JO - Arteriosclerosis, Thrombosis, and Vascular Biology
JF - Arteriosclerosis, Thrombosis, and Vascular Biology
IS - 4
ER -