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

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

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.

MeSH terms

  • Aged
  • Aorta, Abdominal* / diagnostic imaging
  • Aorta, Abdominal* / pathology
  • Aortic Aneurysm, Abdominal* / diagnostic imaging
  • Aortic Aneurysm, Abdominal* / epidemiology
  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / epidemiology
  • Atherosclerosis* / physiopathology
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / surgery
  • Correlation of Data
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / epidemiology
  • Diabetes Mellitus* / physiopathology
  • Disease Progression
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Organ Size
  • Percutaneous Coronary Intervention / methods
  • Tomography, X-Ray Computed / methods*
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / epidemiology