ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Epidemiology and Prevention
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1569886
This article is part of the Research TopicAdvancing Vascular Health: A Comprehensive Framework for Non-Traditional Risk AssessmentView all 6 articles
Risk factors for thoracic aortic aneurysm and dissection among diabetic patients: a nationwide population-based study
Provisionally accepted
Suk Kyung Lim1
Kyungdo Han2Jun Ho Lee3Kyu Na Lee4In Young Cho1Sang-Man Jin1Kiick Sung1
Dong Wook Shin1*Yang Hyun Cho1*- 1Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
- 2Soongsil University, Seoul, Republic of Korea
- 3Korea University, Seoul, Republic of Korea
- 4The Catholic University of Korea, Seoul, Republic of Korea, Seoul, Republic of Korea
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Background: Diabetes mellitus (DM) has been reported to be associated with decreased risk for thoracic aortic aneurysm and dissection (TAAD). However, risk factors for TAAD in diabetic patients remain undetermined. This study aims to investigate diabetes-specific risk factors for TAAD development in diabetic patients.Methods: This population-based study utilized the National Health Insurance Service database in Republic of Korea. We followed 2,328,347 type 2 DM patients undergoing health check-ups from 2009 to 2012 until new TAAD diagnosis, death, or December 31, 2019. Cox proportional-hazards regression models were used to identify risk factors for TAAD development.Results: TAAD was newly diagnosed in 0.02% (4,512/2,328,347) of patients. In the fully-adjusted model incorporating baseline characteristics and antidiabetic medications, the risk for TAAD was increased with age (HR 1.05, 95% CI 1.05-1.06) and males (HR 1.37, 95% CI 1.26-1.49).Meanwhile, the risk of TAAD was decreased in patients with a longer diabetes duration (HR 0.97, 95% CI 0.96-0.99) and metformin use (HR 0.91 95% CI 0.85-0.97).Our study findings suggest that longer diabetes duration and metformin may reduce TAAD risk. Additional research is needed to investigate whether changes in glucose control and treatment strategies can decrease the development of TAAD in diabetic patients.
Keywords: Thoracic aortic dissection and aneurysm, Diabetes Mellitus, Nationwide population-based cohort study, Risk factors, Metformin
Received: 02 Feb 2025; Accepted: 17 Sep 2025.
Copyright: © 2025 Lim, Han, Lee, Lee, Cho, Jin, Sung, Shin and Cho. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Dong Wook Shin, dwshin.md@gmail.com
Yang Hyun Cho, yanghyun.cho@samsung.com
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