Animal and human laboratory studies suggest that the pathogenesis of abdominal aortic aneurysms (AAAs) involves inflammation and degradation and remodeling of the extracellular matrix. This study prospectively assessed the association between biomarkers for these mechanisms and the presence of AAA during 24 years of follow-up in the Atherosclerosis Risk in Communities (ARIC) study. The ARIC prospectively identified clinically diagnosed AAAs in 15 792 men and women from baseline in 1987 to 1989 to 2011 using hospital discharge codes and death records. Additional asymptomatic AAAs were detected by an abdominal ultrasound scan in 2011 to 2013. Matrix metalloproteinase (MMP)-3, MMP-9, interleukin 6 (IL-6), N-terminal propeptide of Type III procollagen (PIIINP), and osteopontin were measured in blood samples collected between 1987 and 1992 in participants with AAA (544 clinically diagnosed AAAs and 72 ultrasound-detected AAAs) and a random sample of 723 participants selected from baseline and matched with AAAs by age, race and sex. Higher concentrations of MMP-9 and IL-6 were associated with future risk of clinically diagnosed AAA (hazard ratios [95% confidence intervals]: 1.55 [1.22-1.97] and 1.87 [1.48-2.35], respectively, comparing highest versus lowest tertiles) after multivariable adjustment (P for trend <.001). Matrix metalloproteinase-9 was also associated with ultrasound-detected AAA. In conclusion, blood concentrations of MMP-9 and IL-6 measured in middle age predicted the risk of AAA during 24 years of follow-up.
Bibliographical noteFunding Information:
As part of a research project grant (R01) study funded by the National Institutes of Health, we measured biomarkers of inflammation and extracellular matrix degradation and remodeling (ie, MMP-3, MMP-9, IL-6, osteopontin, and PIIINP) in plasma samples from middle-aged participants of the Atherosclerosis Risk in Communities (ARIC) Study, a large community-based cohort, and prospectively related their levels to the incidence of AAA during 24 years of follow-up.
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The National Heart, Lung, and Blood Institute supported this research through R01 HL103695 and ARIC contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100 008C, HHSN268201100009C, HHSN268201100010C, HHSN26820 1100011C, and HHSN268201100012C.
- abdominal aortic aneurysm
- extracellular matrix degradation
- longitudinal study