Key result
Diabetes mellitus was not associated with a higher prevalence of aortic valve calcification compared to matched controls without diabetes (52% vs 54%; adjusted OR 0.88, 95% CI 0.80–0.96, p=0.004).
Why the study?
Diabetes mellitus is associated with an increased risk of cardiovascular disease, but its relationship with aortic valve calcification remains unclear.
Is the presence of diabetes mellitus independently associated with a higher prevalence of aortic valve calcification in older adults without known cardiovascular disease?
Cross-Sectional (n=14,182)
Yes
Is the presence of diabetes mellitus independently associated with a higher prevalence of aortic valve calcification in older adults without known cardiovascular disease?
Answers are grounded in this paper and cite their sources.
This large propensity-matched cross-sectional study demonstrates that diabetes mellitus per se is not independently associated with aortic valve calcification, suggesting that AVC burden in diabetic patients is driven by coexisting traditional cardiovascular risk factors and statin use rather than hyperglycaemia.
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.
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Haujir et al. (2026) conducted a cross-sectional in Aortic valve calcification in individuals with and without diabetes mellitus (n=14,182). Diabetes mellitus vs. No diabetes mellitus (propensity score matched) was evaluated on Prevalence of aortic valve calcification (AVC > 0 Agatston units on non-contrast cardiac CT) (OR 0.88, 95% CI 0.80–0.96, p=0.004). Diabetes mellitus was not associated with a higher prevalence of aortic valve calcification compared to matched controls without diabetes (52% vs 54%; adjusted OR 0.88, 95% CI 0.80–0.96, p=0.004).
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