Investigating the inverse association between glycaemia and abdominal aortic dilatation in a large Chinese hypertensive population: a cross-sectional study

Simeng Zhang; Jie Liu; Xin Jia; Tao Zhang; Xianhui Qin; Senhao Jia; Yue Li; Lishun Liu; Yuxiang Song; Shangwei Zuo; Ren Wei; Chen Duan; Zhongyin Wu; Yangyang Ge; Xian Wang; Wei Kong; Xiping Xu; Qiang Wang; Yong Huo; Wei Guo

doi:10.21037/atm-22-1256

Investigating the inverse association between glycaemia and abdominal aortic dilatation in a large Chinese hypertensive population: a cross-sectional study

Ann Transl Med. 2022 Apr;10(7):419. doi: 10.21037/atm-22-1256.

Authors

Simeng Zhang¹, Jie Liu², Xin Jia², Tao Zhang², Xianhui Qin³, Senhao Jia², Yue Li², Lishun Liu³, Yuxiang Song², Shangwei Zuo², Ren Wei², Chen Duan², Zhongyin Wu², Yangyang Ge², Xian Wang^{4

5}, Wei Kong^{4

5}, Xiping Xu³, Qiang Wang¹, Yong Huo⁶, Wei Guo²

Affiliations

¹ Department of Pediatric Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China.
³ National Center for Clinical Research in Kidney Disease, Guangdong Institute of Nephrology, Southern Medical University, Guangzhou, China.
⁴ Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, China.
⁵ Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China.
⁶ Department of Cardiology, Peking University First Hospital, Beijing, China.

Abstract

Background: There is epidemiological evidence that diabetes has a protective effect on the occurrence and development of abdominal aortic aneurysms (AAAs). However, information on the role of glucose level on abdominal aortic diameter is limited. This study sought to assess the relationship between fasting plasma glucose (FPG) and infra-renal aortic diameter in a Chinese hypertensive population.

Methods: The prospective participants comprised candidates from 2 large population-based studies on the clinical presentation and management of hypertension in China. In total, 18,034 hypertensive participants (6,942 male and 11,092 females, with a mean age of 64.72±7.41 years) were included in the study. The maximal diameter of the infra-renal aorta was measured by ultrasound scanning. Multivariate linear regression analyses were conducted to assess the specific association between FPG and abdominal aortic diameter. The interaction terms between the baseline covariables and the aortic diameter were used to determine if a variable affected the association between FPG and abdominal aortic diameter.

Results: Of these, 22 cases of AAA were identified, and the prevalence of diabetes was lower in those with AAA than those without. A significant negative association was also found between FPG and aortic diameter in both sexes. A dose-dependent decrease in the prevalence of diabetes across quartiles of aortic diameter was also observed, with an estimated odds ratio (OR) of 0.60 (95% CI: 0.50-0.72) for men and 0.72 (95% CI: 0.63-0.82) for women for the top quartiles compared to the bottom quartiles. Cigarette smoking only interacted with the association between FPG level and aortic diameter in women. The association did not differ with other subgroups.

Conclusions: Our findings indicate that glycaemia may plays a protective role in the early stage of aortic dilatation in both sexes in a Chinese hypertensive population. Prospective studies need to be conducted to confirm our findings and explore the mechanism underlying this association in different populations.

Keywords: Diabetes; abdominal aortic aneurysm (AAA); aortic dilatation; glycaemia; hypertension.