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

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/m ² , the multivariable hazard ratio (HR [95% CI]) of newly diagnosed AAA was 1.30 [1.06-1.59] for BMI 25-<30 kg/m ² and 1.69 [1.24-2.30] for BMI ≥ 30 kg/m ² . 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.
Competing Interests: 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.