Impact of diabetes mellitus on aortic valve calcification: a cross-sectional study of two large multicentre cohorts
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Diabetes mellitus (DM) is associated with an increased risk of cardiovascular disease, but its relationship with aortic valve calcification (AVC) remains unclear.Objective 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 multicentre cohorts: Steno INTEN-CT (EUCT2022-500143-21-01) and DANCAVAS ( NCT03946410). Participants with available AVC scores assessed by cardiac CT were included in the present study. Propensity score matching was performed to compare participants with DM to those without DM. AVC was analysed as a binary outcome (0 vs >0) using logistic regression with clustering by matched pairs.Results After propensity matching of participants with and without DM, 14 182 participants (7091 matched pairs) were included. Mean age was 67±4 years in the no-DM group compared with 66±4 years in the DM group, p<0.001. AVC was present in 54% and 52% of individuals without and with DM, respectively (p=0.003). In a multivariate logistic regression analysis, DM was not associated with higher AVC prevalence (OR=0.88, 95%CI 0.80–0.96, p=0.004) while male sex, older age, higher body mass index, hypertension, smoking, higher low density lipoprotein cholesterol and statin use remained independently associated with higher prevalence of AVC. An interaction between statin use and DM was found in the association with AVC (p for interaction 0.018), suggesting a potentially stronger association between statin use and AVC among individuals without DM.Conclusion In this large cross-sectional cohort of 14,182 individuals without known cardiovascular disease, the presence of DM was not associated with higher prevalence of AVC. Instead, higher prevalence of AVC was independently associated with cardiovascular risk factors that frequently coexist with DM. These findings suggest that the previously reported relationship between DM and AVC may, at least partly, be related to accompanying cardiovascular risk factors rather than DM per se.
Source: Open Heart
Authors: Amal Haujir, Preman Kumarathurai, Jacob V Stidsen, Per Løgstrup Poulsen, Kristian L Funck, Batool JY Mohammad, Emil Johannes Ravn, Selma Hasific, Camilla Engelsgaard, Remmon Washington, Lene Helleskov Madsen, Monija Mrgan Hansen, Anna Pietraszek, Thomas Kümler, Elena Calderon, Martin Busk, Morten Böttcher, Michael Hecht Olsen, Marek Karon, Jes Sanddal Lindholt, Jess Lambrechtsen, Marie-Annick Clavel, Kristian Altern Øvrehus, Axel Cosmus Pyndt Diederichsen, Jordi Sanchez Dahl
Institutions: Mayo Clinic, University of Southern Denmark, Odense University Hospital, Aarhus University, Aarhus University Hospital, Steno Diabetes Center Aarhus, Steno Diabetes Center Copenhagen, Region of Southern Denmark, Kolding Hospital, Lillebaelt Hospital, Regionshospitalet Silkeborg, Central Denmark Region, Hospital South West Jutland, Aalborg University Hospital, University of Copenhagen, Vejle Sygehus, Region Zealand, Holbæk Sygehus, Sjællands Universitetshospital, Nykøbing F., Centre for Individualised Medicine in Arterial Diseases, Svendborg Sygehus, Institut universitaire de cardiologie et de pneumologie de Québec
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,391
OpenAlex ID: W7224767532