{"title":"2 型糖尿病、代谢特征与腹主动脉瘤之间的关系:跨种族孟德尔随机分析。","authors":"Zelin Niu, Long Cao, Wei Guo, Hongpeng Zhang","doi":"10.1016/j.avsg.2024.07.105","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that type 2 diabetes mellitus (T2DM) may protect from abdominal aortic aneurysm (AAA). However, it is unclear whether a causal relationship exists between these 2 conditions and, if so, whether it remains consistent among racial groups.</p><p><strong>Methods: </strong>Cross-ethnic Mendelian randomization (MR) was used to examine the causal relationships between T2DM, metabolic traits, and AAA. Inverse variance weighted (IVW) was the primary analysis tool, supplemented by MR-Egger, weighted median, and MR Pleiotropy RESidual Sum and Outlier. Heterogeneity and horizontal pleiotropy were assessed using the Cochran's Q test and MR-Egger intercept, respectively.</p><p><strong>Results: </strong>According to IVW, an inverse correlation between T2DM and AAA was detected in Europeans (odds ratio [OR] 0.91, 95% confidence interval [CI] 0.84-0.99; P = 0.034) and East Asians (OR 0.87, 95% CI 0.77-0.99; P = 0.038). Fasting glucose was inversely associated with AAA in Europeans (OR 0.56, 95% CI 0.33-0.96; P = 0.034) but not in East Asians. In Europeans, fasting insulin was a risk factor for AAA (OR 3.03, 95% CI 1.53-6.01; P = 0.001), while 2-hour glucose was protective (OR 0.67, 95% CI 0.49-0.91; P = 0.011). Glycated hemoglobin (HbA1c) had no effect. Insufficient instrumental variables prevented the evaluation of the relationships of fasting insulin, HbA1c, and 2-hour glucose with AAA in East Asians.</p><p><strong>Conclusions: </strong>T2DM protects against AAA in Europeans and East Asians. The effects of different glucose metabolism characteristics on AAA may inform AAA treatment.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations between Type 2 Diabetes Mellitus, Metabolic Traits, and Abdominal Aortic Aneurysm: A Cross-Ethnic Mendelian Randomization Analysis.\",\"authors\":\"Zelin Niu, Long Cao, Wei Guo, Hongpeng Zhang\",\"doi\":\"10.1016/j.avsg.2024.07.105\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Evidence suggests that type 2 diabetes mellitus (T2DM) may protect from abdominal aortic aneurysm (AAA). However, it is unclear whether a causal relationship exists between these 2 conditions and, if so, whether it remains consistent among racial groups.</p><p><strong>Methods: </strong>Cross-ethnic Mendelian randomization (MR) was used to examine the causal relationships between T2DM, metabolic traits, and AAA. Inverse variance weighted (IVW) was the primary analysis tool, supplemented by MR-Egger, weighted median, and MR Pleiotropy RESidual Sum and Outlier. Heterogeneity and horizontal pleiotropy were assessed using the Cochran's Q test and MR-Egger intercept, respectively.</p><p><strong>Results: </strong>According to IVW, an inverse correlation between T2DM and AAA was detected in Europeans (odds ratio [OR] 0.91, 95% confidence interval [CI] 0.84-0.99; P = 0.034) and East Asians (OR 0.87, 95% CI 0.77-0.99; P = 0.038). Fasting glucose was inversely associated with AAA in Europeans (OR 0.56, 95% CI 0.33-0.96; P = 0.034) but not in East Asians. 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引用次数: 0
摘要
背景:有证据表明,2型糖尿病可预防腹主动脉瘤(AAA)。然而,目前还不清楚这两种情况之间是否存在因果关系,如果存在的话,种族群体之间是否保持一致:方法:采用跨种族孟德尔随机法研究 2 型糖尿病、代谢特征和 AAA 之间的因果关系。反方差加权是主要的分析工具,并辅以 MR-Egger、加权中位数和孟德尔随机化多向性 RESidual Sum 和 Outlier。异质性和水平多向性分别采用Cochran's Q检验和MR-Egger截距进行评估:根据逆方差加权法,欧洲人(几率比[OR] 0.91,95%置信区间[CI] 0.84-0.99;P = 0.034)和东亚人(OR 0.87,95%置信区间[CI] 0.77-0.99;P = 0.038)的2型糖尿病与AAA之间存在逆相关性。欧洲人的空腹血糖与 AAA 呈反比关系(OR 0.56,95% CI 0.33-0.96;p = 0.034),而东亚人则不然。在欧洲人中,空腹胰岛素是导致 AAA 的风险因素(OR 3.03,95% CI 1.53-6.01;p = 0.001),而 2 小时血糖具有保护作用(OR 0.67,95% CI 0.49-0.91;p = 0.011)。糖化血红蛋白没有影响。由于工具变量不足,无法评估空腹胰岛素、糖化血红蛋白和2小时血糖与东亚人AAA的关系:结论:2型糖尿病可预防欧洲人和东亚人的动脉粥样硬化。结论:2型糖尿病可预防欧洲人和东亚人的动脉粥样硬化,不同的糖代谢特征对动脉粥样硬化的影响可为动脉粥样硬化的治疗提供参考。
Associations between Type 2 Diabetes Mellitus, Metabolic Traits, and Abdominal Aortic Aneurysm: A Cross-Ethnic Mendelian Randomization Analysis.
Background: Evidence suggests that type 2 diabetes mellitus (T2DM) may protect from abdominal aortic aneurysm (AAA). However, it is unclear whether a causal relationship exists between these 2 conditions and, if so, whether it remains consistent among racial groups.
Methods: Cross-ethnic Mendelian randomization (MR) was used to examine the causal relationships between T2DM, metabolic traits, and AAA. Inverse variance weighted (IVW) was the primary analysis tool, supplemented by MR-Egger, weighted median, and MR Pleiotropy RESidual Sum and Outlier. Heterogeneity and horizontal pleiotropy were assessed using the Cochran's Q test and MR-Egger intercept, respectively.
Results: According to IVW, an inverse correlation between T2DM and AAA was detected in Europeans (odds ratio [OR] 0.91, 95% confidence interval [CI] 0.84-0.99; P = 0.034) and East Asians (OR 0.87, 95% CI 0.77-0.99; P = 0.038). Fasting glucose was inversely associated with AAA in Europeans (OR 0.56, 95% CI 0.33-0.96; P = 0.034) but not in East Asians. In Europeans, fasting insulin was a risk factor for AAA (OR 3.03, 95% CI 1.53-6.01; P = 0.001), while 2-hour glucose was protective (OR 0.67, 95% CI 0.49-0.91; P = 0.011). Glycated hemoglobin (HbA1c) had no effect. Insufficient instrumental variables prevented the evaluation of the relationships of fasting insulin, HbA1c, and 2-hour glucose with AAA in East Asians.
Conclusions: T2DM protects against AAA in Europeans and East Asians. The effects of different glucose metabolism characteristics on AAA may inform AAA treatment.
期刊介绍:
Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal:
Clinical Research (reports of clinical series, new drug or medical device trials)
Basic Science Research (new investigations, experimental work)
Case Reports (reports on a limited series of patients)
General Reviews (scholarly review of the existing literature on a relevant topic)
Developments in Endovascular and Endoscopic Surgery
Selected Techniques (technical maneuvers)
Historical Notes (interesting vignettes from the early days of vascular surgery)
Editorials/Correspondence