Impact of Diabetic Retinopathy on Aortic Valve Calcification in Patients With Type 2 Diabetes

Abstract

Background: Aortic valve calcification (AVC) has a strong association with cardiovascular outcomes in patients with type 2 diabetics (T2D). The objective of this study was to determine the prevalence and risk factors for AVC in Japanese T2D. Methods: We conducted a cross-sectional study of 193 consecutive T2D with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and without overt heart disease (110 men, mean age 61 years). AVC was determined as bright echoes > 1 mm on at least one cusp of the aortic valve by echocardiography. Results: Eighty-two (42%) diabetic patients had AVC, 9 patients had aortic valve stenosis, and 25 had regurgitation. Patients with AVC were older (67 vs. 55 years), with longer diabetic duration (15 vs. 11 years), lower HbA1c (9.1 vs. 10.0%), higher presence of diabetic retinopathy (66 vs. 47%), lower BMI (24 vs. 26 kg/m2), and lower eGFR (82.1 vs. 90.4 mL/min/1.73 m2) (p < 0.01) than patients without AVC. By logistic regression analysis, older age (p < 0.001) and presence of diabetic retinopathy (p < 0.05) were independent risk factors for AVC in T2D. Conclusions: The prevalence of AVC was 42% in Japanese T2D. Diabetic retinopathy associates with presence of AVC.

Keywords

• aortic valve calcification
• diabetic retinopathy
• echocardiography
• type 2 diabetes