Diabetes Mellitus Are Less Likely to Aortic Dissection: A 5-Year Single-Center Analysis on independent risk factors of Aortic Dissection in Diabetes Mellitus Patients

Abstract

Background Diabetes mellitus (DM) is a severe risk factor in most cardiovascular diseases, but is negatively associated with the incidence of acute aortic dissection (AAD). The purpose of this study was to explore the independent risk factors for DM patients who are still with AAD and to establish a nomogram model to predict the risk of AAD in DM patients. Methods Clinical data on 364 DM patients who got surgical indications was collected from January 2016 to December 2021. These patients were divided into negative and positive cohorts according to the diagnosis of AAD. The logistic proportional hazards model was used to find out the risk factors related to DM patients with AAD. A nomogram was generated based on the contribution weights of the independent risk factors. AD mice model was constructed to verify related risk factors in vivo. Results Among 364 patients, AAD occurred in 25 (6.87%) patients. Multivariable logistic regression analysis showed that, after adjusting for confounders, preoperative LDH, hypertension, BMI, and coronary heart disease (CHD) were all positively associated with the risk of AAD in DM patients. (LDH: OR:1.003, 95% Cl: 1.001–1005, p = 0.002; CHD: OR:3.591, 95% Cl: 1.142–11.289, p = 0.029; Hypertension: OR:2.854, 95% Cl: 1.087–7.494, p = 0.033; BMI: OR:1.184, 95% Cl: 1.029–1362, p = 0.018). Pharmacological inhibition of LDH in AAD mice was able to decrease the incidence of AAD from 43.75–13.33%. Conclusion DM patients were negatively associated with AAD, but dysregulated preoperative-LDH、BMI、hypertension and CHD are risk factors for AAD in DM patients.