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Diabetes Mellitus: Is It Protective against Aneurysm? A Narrative Review

机译：糖尿病糖尿病：是否对动脉瘤保护？ 叙述评论

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Objectives: In the course of extensive clinical aortic surgery, we noticed that the aorta was quite thick and fibrotic in diabetic patients. We thought the diabetic aortic aorta might be inimitable to aortic dissection. On this basis, we set out to review information in the literature regarding aortic growth and dissection in diabetic patients. Methods: We used a 2-step search approach to the available literature on diabetes and aneurysm. Firstly, databases including PubMed, Cochrane, Embase and TRIP were searched. Secondly, relevant studies were identified through secondary sources including references of initially selected articles. We address the relationship between diabetes and the incidence, prevalence, growth, mortality and rupture of an aneurysm. Results: Diabetes is thought to exert a protective role in both thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA). Diabetics were shown to have a slower aneurysm growth rate, lower rupture rate, delayed (65 years) age of rupture, decreased rate of mortality from an aneurysm and a decreased length of hospital stay. There was also noted a decreased rate of incidence and prevalence of TAA and AAA in diabetics, smaller aneurysm diameter, reduction in matrix metalloproteinases and an increased aortic wall stress in diabetics. Antidiabetic agents like metformin, thiazolidinediones and dipeptidyl peptidase-4 inhibitors may protect against an aneurysm. Conclusion: Our literature review provides strong (but often circumstantial) evidence that diabetic patients exhibit slower growth of aortic aneurysms and a lower rate of aortic dissection. Furthermore, clinical and experimental studies indicate that common antidiabetic medications on their own inhibit growth of aortic aneurysms. These findings indicate a paradoxically beneficial effect of the otherwise highly detrimental diabetic state. (C) 2018 S. Karger AG, Basel
机译：目的：在广泛的临床主动脉手术过程中，我们注意到主动脉在糖尿病患者中非常厚实，纤维化纤维化。我们认为糖尿病主动脉主动脉可能与主动脉夹层不同。在此基础上，我们列出了患有关于糖尿病患者主动脉生长和解剖的文献中的信息。方法：我们使用了2步搜索方法来糖尿病和动脉瘤的可用文献。首先，搜索包括PubMed，Cochrane，EMBASE和TRIP的数据库。其次，通过次要来源确定相关研究，包括最初选择的文章的参考。我们解决了糖尿病与动脉瘤的发生率和发病，流行，生长，死亡率和破裂的关系。结果：糖尿病被认为在胸主动脉瘤（TAA）和腹主动脉瘤（AAA）中发挥保护作用。糖尿病患者被证明具有较慢的动脉瘤生长速率，较低的破裂率，延迟（＆ 65岁）破裂的年龄，来自动脉瘤的死亡率降低，住院时间减少。还注意到TAA和AAA的发病率和患病率降低，较小的动脉瘤直径，基质金属蛋白酶减少以及糖尿病患者中的主动脉骨胁迫增加。如二甲双胍，噻唑烷二酮和二肽基肽酶-4抑制剂等抗糖尿病药物可以防止动脉瘤。结论：我们的文献综述提供了强大的（但通常是间接的）证据，即糖尿病患者表现出主动脉动脉瘤的速度较慢和主动脉夹层的较低速度。此外，临床和实验研究表明，常见的抗糖尿病药物抑制主动脉瘤的生长。这些发现表明了其他高度不利糖尿病状态的矛盾的有益效果。 （c）2018年S. Karger AG，巴塞尔

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