Diabetes-related factors and abdominal aortic aneurysm events: the Atherosclerotic Risk in Communities Study

Yasuhiko Kubota, Aaron R. Folsom, James S. Pankow, Lynne E. Wagenknecht, Weihong Tang

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: To test the hypothesis that diabetes-related factors (metabolic syndrome [MetS], glucose, insulin, and leptin) are inversely associated with abdominal aortic aneurysm (AAA) risk. Methods: We followed 13,736 participants, aged 45–64 years, without prior AAA surgery at baseline (1987–1989), for AAA occurrence through 2011. Hazard ratios (HRs) and their 95% confidence intervals (CIs) of AAA were calculated using Cox regression. Results: During 275,054 person-years of follow-up, we identified 518 AAA events. Fasting serum glucose was associated inversely with AAA risk (HR [95% CI] per one unit increment in log 2 (glucose), 0.54 [0.36–0.80]), but fasting insulin was not associated with AAA. Plasma leptin was also associated inversely with AAA occurrence (HR [95% CI] per one unit increment in log 2 (leptin), 0.83 [0.71–0.98]). Compared with individuals without MetS, those with MetS had increased risk of AAA (HR [95% CI], 1.24 [1.04–1.48]). Among individuals with or without diabetes, the HRs increased monotonically with a greater number of non-glucose MetS components. Conclusions: Diabetes, fasting glucose, and plasma leptin were inversely associated with risk of AAA. In contrast, the MetS was associated with increased risk of AAA, due to the influence of the non-glucose MetS components.

Original languageEnglish (US)
Pages (from-to)102-106.e1
JournalAnnals of epidemiology
Issue number2
StatePublished - Feb 2018

Bibliographical note

Funding Information:
Funding sources: This work was supported by the National Heart, Lung, and Blood Institute (NHLBI) via contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, HHSN268201100012C, and R01 HL103695. The Nippon Foundation provided grants to support Dr. Kubota's fellowship at School of Public Health, University of Minnesota.

Publisher Copyright:
© 2018 Elsevier Inc.


  • Abdominal aortic aneurysm
  • Diabetes
  • Leptin
  • Metabolic syndrome


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