Association between metformin prescription and growth rates of abdominal aortic aneurysms

J. Golledge, J. Moxon, J. Pinchbeck, G. Anderson, S. Rowbotham, J. Jenkins, M. Bourke, B. Bourke, A. Dear, T. Buckenham, R. Jones, P. E. Norman

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    Abstract

    Background: It has been suggested that diabetes medications, such as metformin, may have effects that inhibit abdominal aortic aneurysm (AAA) growth. The aim of this study was to examine the association of diabetes treatments with AAA growth in three patient cohorts. Methods: AAA growth was studied using ultrasound surveillance in cohort 1, repeated CT in cohort 2 and more detailed repeat CT in cohort 3. Growth was estimated by the mean annual increase in maximum AAA diameter. Results: A total of 1697 patients with an AAA were studied, of whom 118, 39 and 16 patients were prescribed metformin for the treatment of diabetes in cohorts 1, 2 and 3 respectively. Prescription of metformin was associated with a reduced likelihood of median or greater AAA growth in all three cohorts (cohort 1: adjusted odds ratio (OR) 0·59, 95 per cent c.i. 0·39 to 0·87, P = 0·008; cohort 2: adjusted OR 0·38, 0·18 to 0·80, P = 0·011; cohort 3: adjusted OR 0·13, 0·03 to 0·61, P = 0·010). No other diabetes treatment was significantly associated with AAA growth in any cohort. Conclusion: These findings suggest a potential role for metformin in limiting AAA growth.

    Original languageEnglish
    Pages (from-to)1486-1493
    Number of pages8
    JournalBritish Journal of Surgery
    Volume104
    Issue number11
    DOIs
    Publication statusPublished - 1 Oct 2017

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    Metformin
    Abdominal Aortic Aneurysm
    Prescriptions
    Growth
    Odds Ratio
    Therapeutics

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    Golledge, J., Moxon, J., Pinchbeck, J., Anderson, G., Rowbotham, S., Jenkins, J., ... Norman, P. E. (2017). Association between metformin prescription and growth rates of abdominal aortic aneurysms. British Journal of Surgery, 104(11), 1486-1493. https://doi.org/10.1002/bjs.10587
    Golledge, J. ; Moxon, J. ; Pinchbeck, J. ; Anderson, G. ; Rowbotham, S. ; Jenkins, J. ; Bourke, M. ; Bourke, B. ; Dear, A. ; Buckenham, T. ; Jones, R. ; Norman, P. E. / Association between metformin prescription and growth rates of abdominal aortic aneurysms. In: British Journal of Surgery. 2017 ; Vol. 104, No. 11. pp. 1486-1493.
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    abstract = "Background: It has been suggested that diabetes medications, such as metformin, may have effects that inhibit abdominal aortic aneurysm (AAA) growth. The aim of this study was to examine the association of diabetes treatments with AAA growth in three patient cohorts. Methods: AAA growth was studied using ultrasound surveillance in cohort 1, repeated CT in cohort 2 and more detailed repeat CT in cohort 3. Growth was estimated by the mean annual increase in maximum AAA diameter. Results: A total of 1697 patients with an AAA were studied, of whom 118, 39 and 16 patients were prescribed metformin for the treatment of diabetes in cohorts 1, 2 and 3 respectively. Prescription of metformin was associated with a reduced likelihood of median or greater AAA growth in all three cohorts (cohort 1: adjusted odds ratio (OR) 0·59, 95 per cent c.i. 0·39 to 0·87, P = 0·008; cohort 2: adjusted OR 0·38, 0·18 to 0·80, P = 0·011; cohort 3: adjusted OR 0·13, 0·03 to 0·61, P = 0·010). No other diabetes treatment was significantly associated with AAA growth in any cohort. Conclusion: These findings suggest a potential role for metformin in limiting AAA growth.",
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    Golledge, J, Moxon, J, Pinchbeck, J, Anderson, G, Rowbotham, S, Jenkins, J, Bourke, M, Bourke, B, Dear, A, Buckenham, T, Jones, R & Norman, PE 2017, 'Association between metformin prescription and growth rates of abdominal aortic aneurysms' British Journal of Surgery, vol. 104, no. 11, pp. 1486-1493. https://doi.org/10.1002/bjs.10587

    Association between metformin prescription and growth rates of abdominal aortic aneurysms. / Golledge, J.; Moxon, J.; Pinchbeck, J.; Anderson, G.; Rowbotham, S.; Jenkins, J.; Bourke, M.; Bourke, B.; Dear, A.; Buckenham, T.; Jones, R.; Norman, P. E.

    In: British Journal of Surgery, Vol. 104, No. 11, 01.10.2017, p. 1486-1493.

    Research output: Contribution to journalArticle

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    AU - Jenkins, J.

    AU - Bourke, M.

    AU - Bourke, B.

    AU - Dear, A.

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    AU - Norman, P. E.

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    AB - Background: It has been suggested that diabetes medications, such as metformin, may have effects that inhibit abdominal aortic aneurysm (AAA) growth. The aim of this study was to examine the association of diabetes treatments with AAA growth in three patient cohorts. Methods: AAA growth was studied using ultrasound surveillance in cohort 1, repeated CT in cohort 2 and more detailed repeat CT in cohort 3. Growth was estimated by the mean annual increase in maximum AAA diameter. Results: A total of 1697 patients with an AAA were studied, of whom 118, 39 and 16 patients were prescribed metformin for the treatment of diabetes in cohorts 1, 2 and 3 respectively. Prescription of metformin was associated with a reduced likelihood of median or greater AAA growth in all three cohorts (cohort 1: adjusted odds ratio (OR) 0·59, 95 per cent c.i. 0·39 to 0·87, P = 0·008; cohort 2: adjusted OR 0·38, 0·18 to 0·80, P = 0·011; cohort 3: adjusted OR 0·13, 0·03 to 0·61, P = 0·010). No other diabetes treatment was significantly associated with AAA growth in any cohort. Conclusion: These findings suggest a potential role for metformin in limiting AAA growth.

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    Golledge J, Moxon J, Pinchbeck J, Anderson G, Rowbotham S, Jenkins J et al. Association between metformin prescription and growth rates of abdominal aortic aneurysms. British Journal of Surgery. 2017 Oct 1;104(11):1486-1493. https://doi.org/10.1002/bjs.10587