Impact of Diabetes Mellitus on the Aortic Wall Changes as Atherosclerosis Progresses: Aortic Dilatation and Calcification
Impact of Diabetes Mellitus on the Aortic Wall Changes as Atherosclerosis Progresses: Aortic Dilatation and Calcification
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DOI：
10.5551/jat.50930
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发表时间：
2020-01-01
影响因子：
4.4
通讯作者：
Murohara, Toyoaki
中科院分区：
文献类型：
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作者：
Iwakawa, Naoki;Tanaka, Akihito;Murohara, Toyoaki
目的：最近有报道称糖尿病（DM）与主动脉扩张呈负相关。然而，随着动脉粥样硬化的进展，糖尿病与主动脉扩张/钙化进展之间的关系知之甚少。方法：216例经皮冠状动脉介入治疗（PCI）和腹部计算机断层扫描（CT）的患者。将患者分为两组：DM+组（n=107）和非DM组（n=109）。测量肾下主动脉直径和主动脉钙化指数（ACI），并根据PCI和随访期间的测量结果计算年变化。结果：PCI期DM+组肾下主动脉直径明显短于DM-组，且两组间ACI差异无统计学意义。PCI和随访期CT之间的中位持续时间为3.0年。DM+组PCI期肾下主动脉扩张的增长速度与DM-组相似。DM+组ACI的年变化明显大于DM-组。多因素logistic回归分析显示，糖尿病患病率是主动脉钙化快速进展的独立预测因子（优势比：2.51；95%可信区间：1.23-5.14;p= 0.01）。结论：我们的研究结果表明，在动脉粥样硬化进展的早期阶段，DM对主动脉扩张有负面影响，而在后期阶段，DM对主动脉钙化的进展有积极影响。
Aim: An inverse association between diabetes mellitus (DM) and aortic dilatation has recently been reported. However, little is known about the association between DM and the progression of aortic dilatation/calcification as atherosclerosis progresses.Methods: We identified 216 patients who had undergone percutaneous coronary intervention (PCI) and abdominal computed tomography (CT) during the PCI and follow-up phases. The patients were classified into two groups: those with DM (DM+ group; n=107) and those without DM (DM- group; n=109). The infrarenal aortic diameter and aortic calcification index (ACI) were measured, and annual changes were calculated using measurement results obtained during the PCI and follow-up phases.Results: Infrarenal aortic diameters were significantly shorter in the DM+ group than in the DM- group during the PCI phase, and no significant ACI differences were observed between the DM+ and DM- groups. The median duration between the PCI and follow-up phase CT was 3.0 years. The growth rate of the infrarenal aortic dilatation from the PCI phase in the DM+ group was similar to that in the DM- group. Annual ACI changes were significantly larger in the DM+ group than in the DM- group. Multivariate logistic regression analysis indicated that the prevalence of DM was an independent predictor of rapid aortic calcification progression (odds ratio: 2.51; 95% confidence interval: 1.23-5.14; p= 0.01).Conclusion: Our findings suggest that DM negatively affects aortic dilatation during an earlier phase of atherosderosis progression and positively affects the progression of aortic calcification in a later phase.