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Original research article
Metformin prescription and aortic aneurysm: systematic review and meta-analysis
  1. Xinyu Yu1,
  2. Dingsheng Jiang1,2,3,4,
  3. Jing Wang1,
  4. Rui Wang1,
  5. Taiqiang Chen1,
  6. Kan Wang1,
  7. Mouniir Sha Ahmad Durgahee1,
  8. Xiang Wei1,2,3,4,
  9. Shiyi Cao5
  1. 1 Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  2. 2 Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China
  3. 3 NHC Key Laboratory of Organ Transplantation, Wuhan, China
  4. 4 Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China
  5. 5 School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  1. Correspondence to Xiang Wei, Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; xiangwei{at}tjh.tjmu.edu.cn and Dr Shiyi Cao, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; caoshiyi{at}hust.edu.cn

Abstract

Objective To assess the association of metformin prescription with the risk of aortic aneurysm, aortic aneurysm events and the enlargement of abdominal aortic aneurysm (AAA).

Design Systematic review and meta-analysis.

Methods We searched PubMed, Embase and Scopus for epidemiological studies up to November 2018. We included observational studies which evaluated the association of metformin prescription with the risk of aortic aneurysm disease, and we also included studies involving progression and enlargement of AAA. The Newcastle-Ottawa Scale was used to assess the quality of included studies. Random-effect meta-analyses were conducted in line with the between-study heterogeneity. Sensitivity analyses were performed to identify the source of heterogeneity.

Results Eight studies enrolling 29 587 participants met the inclusion criteria and were included in this systematic review. We found that metformin prescription could significantly limit the enlargement of aortic aneurysm (weighted mean difference: −0.83 mm/year, 95% CI −1.38 to −0.28, I2=89.6%) among patients with AAA. Metformin prescription status may be associated with a decreased risk of aortic aneurysm and aortic aneurysm events.

Conclusions According to the available epidemiological evidence, metformin prescription could limit the expansion of AAA among patients with this disease, and may be involved with a lower incidence of aortic aneurysm and aortic aneurysm events. Randomised controlled trials are needed to confirm whether metformin could reduce the enlargement of AAA in patients with or without diabetes.

  • metformin
  • aortic aneurysm
  • meta-analysis
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Footnotes

  • Funding This review was supported by the National Natural Science Foundation of China (NSFC, 71603091).

  • Competing interests None declared.

  • Ethics approval Ethical approval was not necessary for this systematic review.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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