AAA - and diabetes

 Q: Diabetes mellitus has a protective effect in an expansion of the Aortic Abdominal Aneurysm (AAA)?

A) True

B) False

Answer: A

Diabetes mellitus has a negative association and appears to have a protective effect against the expansion of AAA. Diabetic patients have a 25 to 40 percent less chance of expansion of AAA when compared to patients without diabetes. This is due to increased arterial stiffness/atherosclerosis occurring in the aorta due to diabetes. Said that, despite this negative effect on expansion of AAA, it is unknown if this prevents the rupture. 

Interestingly, with the same mechanism there is a negative association between the history of coronary artery disease and AAA expansion.

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References:

1. Bhak RH, Wininger M, Johnson GR, et al. Factors associated with small abdominal aortic aneurysm expansion rate. JAMA Surg 2015; 150:44.

2. Sweeting MJ, Thompson SG, Brown LC, et al. Meta-analysis of individual patient data to examine factors affecting growth and rupture of small abdominal aortic aneurysms. Br J Surg 2012; 99:655.

3. Salomaa V, Riley W, Kark JD, et al. Non-insulin-dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes. The ARIC Study. Atherosclerosis Risk in Communities Study. Circulation 1995; 91:1432. 

4. Takagi H, Umemoto T, ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. Coronary artery disease and abdominal aortic aneurysm growth. Vasc Med 2016; 21:199.