A population-based study on hyperinsulinaemia and arterial stiffness in men with and without abdominal aortic aneurysm

Shahab Fatemi; Stefan Acosta; Moncef Zarrouk; Peter M Nilsson; Anders Gottsäter

doi:10.1097/XCE.0000000000000290

A population-based study on hyperinsulinaemia and arterial stiffness in men with and without abdominal aortic aneurysm

Cardiovasc Endocrinol Metab. 2023 Sep 18;12(4):e0290. doi: 10.1097/XCE.0000000000000290. eCollection 2023 Dec.

Authors

Shahab Fatemi^{1

2}, Stefan Acosta^{1

3}, Moncef Zarrouk^{1

3}, Peter M Nilsson^{1

4}, Anders Gottsäter^{1

4}

Affiliations

¹ Department of Clinical Sciences, Lund University, Malmö.
² Department of Medicine, Trelleborg Hospital.
³ Departments of Cardiothoracic and Vascular Surgery.
⁴ Internal and Emergency Medicine, Skåne University Hospital, Malmö, Sweden.

Abstract

Objectives: Patients with type 2 diabetes mellitus (DM) run lower risk for abdominal aortic aneurysm (AAA, aortic diameter ≥ 30 mm) and its complications. We aimed to evaluate associations between disturbances in glucose metabolism and arterial stiffness, AAA, and abdominal aortic diameter in 65-year-old men.

Methods: Forty-eight 65-year-old men with screening-detected AAA and 115 men with normal abdominal aortic diameter underwent examination of glucose metabolism and arterial stiffness.

Results: Men with AAA had higher BMI, waist-hip ratio (WHR), frequency of DM, haemoglobin A_1c, smoking exposure, and plasma insulin levels at 0, 60 and 120 min during OGTT compared to those without. The increase in p-insulin (P < 0.001) after OGTT was also higher in men with AAA, adjusted for smoking, WHR, and nadir value of p-insulin. In analyses adjusted for smoking, use of lipid-lowering agents, and WHR, the increase in p-insulin at 2-hours (P = 0.006) after OGTT and p-homocysteine were associated with abdominal aortic diameter. There were no differences between groups in aortic stiffness or skin autofluorescence Advanced Glycation End products.

Conclusion: In this population-based study hyperinsulinaemia as a marker of insulin resistance, but not hyperglycaemia or aortic stiffness, was associated with AAA and abdominal aortic diameter in 65-year-old men.

Keywords: abdominal aortic aneurysm; aortic diameter; arterial stiffness; atherosclerosis; diabetes mellitus; hyperinsulinaemia; metabolic syndrome; screening.