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. 2020 Jun 1;27(6):509-515.
doi: 10.5551/jat.50930. Epub 2019 Sep 25.

Impact of Diabetes Mellitus on the Aortic Wall Changes as Atherosclerosis Progresses: Aortic Dilatation and Calcification

Naoki Iwakawa  1 , Akihito Tanaka  1 , Hideki Ishii  1 , Takashi Kataoka  1 , Kiyoshi Niwa  1 , Yusuke Hitora  1 , Hiroshi Tashiro  1 , Takayuki Mitsuda  1 , Hiroki Kojima  1 , Kenshi Hirayama  1 , Kenji Furusawa  1 , Ruka Yoshida  1 , Susumu Suzuki  1 , Toyoaki Murohara  1
Affiliations

Impact of Diabetes Mellitus on the Aortic Wall Changes as Atherosclerosis Progresses: Aortic Dilatation and Calcification

Naoki Iwakawa et al. J Atheroscler Thromb. .

Abstract

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 atherosclerosis progression and positively affects the progression of aortic calcification in a later phase.

Keywords: Aortic calcification; Aortic dilatation; Atherosclerosis; Coronary artery disease; Diabetes mellitus.

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Conflict of interest statement

Hideki Ishii received lecture fees from Astellas Pharma Inc., Astrazeneca Inc., Daiichi-Sankyo Pharma Inc., and MSD K. K. Toyoaki Murohara received lecture fees from Bayel Pharmaceutical Co., Ltd., Daiichi-Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K. K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K. K., Pfizer Japan Inc., Sanofi-aventis K. K., and Takeda Pharmaceutical Co., Ltd. Toyoaki Murohara received unrestricted research grant for Department of Cardiology, Nagoya University Graduate School of Medicine from Astellas Pharma Inc., Daiichi-Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K. K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K. K., Otsuka Pharma Ltd., Pfizer Japan Inc., Sanofiaventis K. K., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

Fig. 1.
Fig. 1.
Changes in influence of DM on aortic wall as atherosclerosis progresses
See this image and copyright information in PMC

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