Impact of diabetes mellitus on aortic valve calcification – a cross-sectional study of two large multicenter cohorts
A Haujir, P Kumarathurai, J V Stidsen, P L Poulsen, K L Funck, M A Clavel, K A Ovrehus, A C P Diederichsen, J S DahlAbstract
Background
Diabetes mellitus (DM) is associated with an increased risk of cardiovascular disease, but its relationship with aortic valve calcification (AVC) remains unclear.
Aim
The present study aims to investigate whether the presence of DM is associated with a higher prevalence of AVC.
Methods
This cross-sectional study combines two large multicenter cohorts: the Steno Inten-CT and DANCAVAS studies. The Steno INTEN-CT study is an ongoing randomized controlled trial using cardiac computed tomography (CT) for cardiovascular risk stratification in individuals with DM, aged 55-69 years (men) and 60-74 (women). DANCAVAS trial is a population-based cardiovascular screening study conducted between 2014 and 2019 that enrolled individuals aged 60-74 years. Participants with available AVC scores were included in the present study. Propensity score matching was performed, and AVC was analyzed as binary outcome (0 vs > 0) using logistic regression with clustering by matched pairs. Univariate and multivariable analyses were performed.
Results
AVC was available in 17,059 participants, and after propensity matching, 5,608 pairs were included in the analysis. Univariate analysis identified age (OR 1.11, 95% CI 1.10-1.23, p <0.001), male sex (OR 1.49, 95% CI 1.37-1.63, p <0.001), BMI (OR 1.03, 95% CI 1.02-1.04, p <0.001), hypertension (OR 1.67, 95% CI 1.54-1.80, < 0.001) LDL cholesterol (OR 1.06, 95% CI 1.01 – 1.10, p = 0.015), smoking (OR 1.32, 95% CI 1.22-1.43, p <0.001), impaired renal function (OR 1.19, 95% CI 1.05-1.36, p = 0.008), and statin use (OR 1.48, 95 % CI 1.37-1.59, p < 0.001) as associated with the presence of AVC. However, DM did not associate with the presence of AVC (OR 0.92, 95% CI 0.86-0.99, p = 0.046). In a multivariable model, age, sex, BMI, hypertension, LDL, and smoking status remained independently associated with AVC, whereas DM was not (OR 1.04, 95% CI 0.95–1.14; p = 0.395).
Conclusion
In this population-based study, DM was not associated with AVC. Instead, traditional cardiovascular risk factors were associated with increased odds of having AVC.Forest plotAortic Valve Calcification on CT