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Randomized Controlled Trial
. 2017:2017:3521649.
doi: 10.1155/2017/3521649. Epub 2017 Feb 23.

Associations of Diabetes and Obesity with Risk of Abdominal Aortic Aneurysm in Men

Lu Wang  1 , Luc Djousse  2 , Yiqing Song  3 , Akintunde O Akinkuolie  1 , Chisa Matsumoto  4 , JoAnn E Manson  5 , J Michael Gaziano  6 , Howard D Sesso  7
Affiliations
Randomized Controlled Trial

Associations of Diabetes and Obesity with Risk of Abdominal Aortic Aneurysm in Men

Lu Wang et al. J Obes. 2017.

Abstract

Background. The associations of diabetes and obesity with the risk of abdominal aortic aneurysm (AAA) are inconclusive in previous studies. Subjects/Methods. We conducted prospective analysis in the Physicians' Health Study. Among 25,554 male physicians aged ≥ 50 years who reported no AAA at baseline, 471 reported a newly diagnosed AAA during a mean of 10.4 years' follow-up. Results. Compared with men who had baseline body mass index (BMI) < 25 kg/m2, the multivariable hazard ratio (HR [95% CI]) of newly diagnosed AAA was 1.30 [1.06-1.59] for BMI 25-<30 kg/m2 and 1.69 [1.24-2.30] for BMI ≥ 30 kg/m2. The risk of diagnosed AAA was significantly higher by 6% with each unit increase in baseline BMI. This association was consistent regardless of the other known AAA risk factors and preexisting vascular diseases. Overall, baseline history of diabetes tended to be associated with a lower risk of diagnosed AAA (HR = 0.79 [0.57-1.11]); this association appeared to vary by follow-up time (HR = 1.56 and 0.63 during ≤ and >2 years' follow-up, resp.). Conclusion. In a large cohort of middle-aged and older men, obesity was associated with a higher risk, while history of diabetes tended to associate with a lower risk of diagnosed AAA, particularly over longer follow-up.

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Conflict of interest statement

Dr. Lu Wang was supported by a K99/R00 grant HL095649 from the National Heart, Lung, and Blood Institutes (NHLBI), the National Institutes of Health (NIH). Dr. Howard D. Sesso has received investigator-initiated research funding from the NIH, Pfizer Inc., Mars Symbioscience, and the Council for Responsible Nutrition Foundation. Dr. JoAnn E. Manson has received investigator-initiated research funding from the NIH and Mars Symbioscience and assistance with study pills and packaging from Pronova BioPharma/BASF and Pharmavite for the VITamin D and OmegA-3 TriaL. Dr. J. Michael Gaziano has received investigator-initiated research funding from the NIH, the Veterans Administration, and BASF Corporation to assist in the establishment of this trial cohort; assistance with study agents and packaging from BASF Corporation and Pfizer (formerly Wyeth, American Home Products, and Lederle); and assistance with study packaging provided by DSM Nutritional Products Inc. (formerly Roche Vitamins). No other authors reported any competing interests.

Figures

Figure 1
Figure 1
Flow diagram of participants in the Physicians' Health Study (PHS) I and II that are included in the current analysis.
Figure 2
Figure 2
Cumulative incidence of clinically diagnosed AAA according to baseline BMI (a) and history of diabetes (b). Multivariable model adjusted for age, race, randomized treatment assignment, smoking status, alcohol use, vigorous exercise, history of cardiovascular disease, hypertension, and hypercholesterolemia. Model for BMI also adjusted for history of diabetes, and vice versa.
See this image and copyright information in PMC

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