Impact of diabetes mellitus on the aortic wall changes as atherosclerosis progresses: Aortic dilatation and calcification

Naoki Iwakawa, Akihito Tanaka, Hideki Ishii, Takashi Kataoka, Kiyoshi Niwa, Yusuke Hitora, Hiroshi Tashiro, Takayuki Mitsuda, Hiroki Kojima, Kenshi Hirayama, Kenji Furusawa, Ruka Yoshida, Susumu Suzuki, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


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 aor-tic 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 indi-cated 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.

Original languageEnglish
Pages (from-to)509-515
Number of pages7
JournalJournal of atherosclerosis and thrombosis
Issue number6
Publication statusPublished - 2020

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Biochemistry, medical


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