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T2D Tied to Less Aortic Aneurysm Risk

— Does diabetes somehow strengthen vessel wall?

MedpageToday

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LISBON -- Type 2 diabetes may come with a thin silver lining: reduced risk of aortic aneurysm and dissection, a Swedish population-based study suggested.

Diabetes was associated with 28% lower risk of aortic aneurysm (adjusted HR 0.72, 95% CI 0.68-0.76), with an incidence rate of 80.4 versus 93.3 per 100,000 patient-years compared with matched controls, reported Tarik Avdic, MD, from the Swedish National Diabetes Register in Gothenburg, here at the meeting.

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

For aortic dissection, the risk was 47% lower risk than in the matched controls (adjusted HR 0.53, 95% CI 0.42-0.65), with incidence rates of 5.6 versus 11.2 per 100,000 patient-years.

The risk difference stood in most contrast for thoracic aortic aneurysms but was seen across all types of aortic aneurysm in the study of 448,319 people with type 2 diabetes and 2.25 million controls matched for age, sex, and county of residence.

Unadjusted survival following hospitalization for aortic aneurysm was also better with type 2 diabetes, at least in the first couple of years out of the mean of about 7 years of follow-up.

While Avdic cautioned that the study was observational (and thus could not determine causality or mechanism), he noted at a press briefing that the findings expand on prior studies showing a similarly lower risk of abdominal aortic aneurysm in type 2 diabetes.

"There are studies before that have shown that diabetes perhaps makes the aortic wall stronger," Avdic said, suggested to be by making stronger cross links in the wall itself and possibly less inflammatory response as well.

Also, "maybe because these patients are prone to cardiovascular mortality and also morbidity they have maybe stricter blood lipid controls and also blood pressure controls, but in this case we have adjusted for this," he added, calling for further studies.

"I'm amazed. It's unusual to find something that's less of a risk for type 2 diabetes patients," commented Robert Ryder, MD, of City Hospital in Birmingham, England, who was not involved in the study.

And, in fact, it might be the first disease associated with reduced risk of aortic aneurysm, Avdic added.

Disclosures

Avdic and co-authors disclosed no relevant relationships with industry.

Primary Source

European Association for the Study of Diabetes

Avdic T, et al "Long term risk of aortic aneurysm and aortic dissection among individuals with type 2 diabetes: a nationwide observational study" EASD 2017; Abstract 84.