A Case-Control Study of Risk Factors of Abdominal Aortic Aneurysm
DOI:
https://doi.org/10.1532/hsf.1415Abstract
Objective: To explore the potential risk factors of abdominal aortic aneurysm (AAA) in the Chinese population.Methods: A matched case-control study was designed for the study. Patients with AAA administrated in the First Affiliated Hospital of Zhengzhou University from January 2005 to December 2007 were included in the study. Sex and age-matched volunteers were selected for the case-control in the same period. A uniform questionnaire was sent to patients and volunteers to collect demographic data, past medical history, and behavioral factors. General physical examination, ultrasound examination of the abdominal aorta, and serological testing were used to collect clinical data. Environmental risk factors of abdominal aortic aneurysms were analyzed by conditional logistic regression.
Results: A total of 465 subjects including 155 patients were enrolled in the study. Multivariate regression analysis found that people with high blood pressure have high risk of AAA (OR = 1.88, 95% CI 1.12-3.18; P = .02). Smoking is a significant independent risk factor for AAA; the morbidity of AAA in smokers is 5.23-fold of non-smokers (95% CI 2.44-11.23). Dyslipidemia (OR = 2.61, 95% CI 1.45-4.70), serum high sensitivity C-reactive protein (OR = 2.43, 95% CI 1.37-4.31), and homocysteine (OR = 2.73, 95% CI 1.61-4.65) were valuable parameters in detecting AAA.
Conclusion: Hypertension and smoking are risk factors of abdominal aortic aneurysms; dyslipidemia, high-sensitivity C-reactive protein, and homocysteine levels are associated with AAA.
References
Agroyannis, B., A. Chatziioannou, D. Mourikis, et al. (2002). “Abdominal aortic aneurysm and renal artery stenosis: renal function and blood pressure before and after endovascular treatment.” J Hum Hypertens 16(5): 367-369.
Badger, S. A., M. E. O’Donnell, M. A. Sharif, et al. (2009). “The role of smoking in abdominal aortic aneurysm development.” Angiology 60(1): 115-119.
Basso, R. D., T. Sandgren, A. R. Ahlgren and T. Lanne (2015). “Increased cardiovascular risk without generalized arterial dilating diathesis in persons who do not have abdominal aortic aneurysm but who are first-degree relatives of abdominal aortic aneurysm patients.” Clin Exp Pharmacol Physiol 42(6): 576-581.
Bath, M. F., V. J. Gokani, D. A. Sidloff, et al. (2015). “Systematic review of cardiovascular disease and cardiovascular death in patients with a small abdominal aortic aneurysm.” Br J Surg 102(8): 866-872.
Bird, A. N. and A. M. Davis (2015). “Screening for abdominal aortic aneurysm.” JAMA 313(11): 1156-1157.
Eugster, T., A. Huber, T. Obeid, et al. (2005). “Aminoterminal propeptide of type III procollagen and matrix metalloproteinases-2 and -9 failed to serve as serum markers for abdominal aortic aneurysm.” Eur J Vasc Endovasc Surg 29(4): 378-382.
Forsdahl SH, Singh K, Solberg S, Jacobsen BK. 2009. Risk factors for abdominal aortic aneurysms: a 7-year prospective study: the Tromsø Study, 1994-2001. Circulation 119:2202-8.
Jacob, A. D., P. L. Barkley, K. C. Broadbent et al. (2015). “Abdominal aortic aneurysm screening.” Semin Roentgenol 50(2): 118-126.
Johansson, M., A. Hansson and J. Brodersen (2015). “Estimating overdiagnosis in screening for abdominal aortic aneurysm: could a change in smoking habits and lowered aortic diameter tip the balance of screening towards harm?” BMJ 350: h825.
Kaneko, H., T. Anzai, K. Horiuchi, et al. (2011). “Tumor necrosis factor-alpha converting enzyme is a key mediator of abdominal aortic aneurysm development.” Atherosclerosis 218(2): 470-478.
Khashram, M., G. T. Jones and J. A. Roake (2015). “Prevalence of Abdominal Aortic Aneurysm (AAA) in a Population Undergoing Computed Tomography Colonography in Canterbury, New Zealand.” Eur J Vasc Endovasc Surg.
Koole, D., F. L. Moll, J. Buth, R. Hobo, et al. (2012). “The influence of smoking on endovascular abdominal aortic aneurysm repair.” J Vasc Surg 55(6): 1581-1586.
Liu, Z., H. Luo, L. Zhang, et al. (2012). “Hyperhomocysteinemia exaggerates adventitial inflammation and angiotensin II-induced abdominal aortic aneurysm in mice.” Circ Res 111(10): 1261-1273.
Maegdefessel, L., J. Azuma, R. Toh, et al. (2012). “MicroRNA-21 blocks abdominal aortic aneurysm development and nicotine-augmented expansion.” Sci Transl Med 4(122): 122ra122.
Meijer, C. A., V. B. Kokje, R. B. van Tongeren, et al. (2012). “An association between chronic obstructive pulmonary disease and abdominal aortic aneurysm beyond smoking: results from a case-control study.” Eur J Vasc Endovasc Surg 44(2): 153-157.
Parmar, G. M., B. Lowman, B. R. Combs, et al. (2013). “Effect of lipid-modifying drug therapy on survival after abdominal aortic aneurysm repair.” J Vasc Surg 58(2): 355-363.
Powell, J. T., B. R. Muller and R. M. Greenhalgh (1987). “Acute phase proteins in patients with abdominal aortic aneurysms.” J Cardiovasc Surg (Torino) 28(5): 528-530.
Sharif, M. A., D. A. McDowell and S. A. Badger (2013). “Chlamydia pneumoniae antibodies and C-reactive protein levels in patients with abdominal aortic aneurysms.” ScientificWorldJournal 2013: 212450.
Stackelberg, O., M. Bjorck, S. C. Larsson, et al.(2014). “Alcohol consumption, specific alcoholic beverages, and abdominal aortic aneurysm.” Circulation 130(8): 646-652.