Association of ALOX12-Mediated AA/12-HETE Metabolic Dysregulation with Abdominal Aortic Aneurysm Enlargement and Dissection.

Abdominal aortic aneurysm (AAA) enlargement is a major risk factor for aneurysm rupture and the development of abdominal aneurysm dissection (AAD). However, reliable serum biomarkers for predicting AAD occurrence remain lacking. This study was designed to identify circulating serum markers capable of predicting AAA progression and AAD formation. Patients diagnosed with AAA or AAD at our institution between 2020 and 2025 were enrolled and corresponding clinical characteristics were analyzed. Peripheral blood levels of arachidonic acid (AA) and 12-HETE were measured using ELISA, and Alox12 mRNA expression was determined by quantitative real-time polymerase chain reaction (qRT-PCR). Candidate serum biomarkers associated with AAA enlargement and AAD development were investigated using a multi-modal approach integrating computed tomography (CT) images, serum metabolic profiles, and aneurysm wall tissue analyses. A total of 52 AAA patients and 42 AAA patients were included in the analysis. Elevated serum 12-HETE and TG levels were significantly associated with AAA enlargement and the occurrence of AAD, whereas AA levels showed no significant difference between groups. Dysregulated AA/12-HETE metabolism is an independent risk factor for aneurysmal enlargement in AAA and AAD, while 12-HETE and TG help to discriminate AAD from AAA.