A potential role for glycated cross-links in abdominal aortic aneurysm disease

Diabetes is negatively associated with progression of abdominal aortic aneurysm (AAA). We hypothesized that glycation of AAA tissue protects against proteolytic breakdown. Advanced glycation end products (AGEs) were measured in AAA biopsies (30 diabetics vs 30 nondiabetics). Higher levels of AGEs in diabetic AAA tissue were observed, and in vitro glycated AAA biopsies were more resistant against proteolysis. AGEs were correlated negatively with aortic diameter. These findings suggest that AGEs play a protective role in AAA progression. Metformin inhibits the formation of AGEs. Patients with diabetes and AAA disease might have decreased AAA progression if they switch to another oral antidiabetic or insulin.