Abstract
Background: Little is known about the association between abdominal aortic calcification (AAC) and the risk of cardiovascular disease (CVD) among patients with diabetes. This study evaluated the cross-sectional association between AAC and CVD morbidity in patients with type 2 diabetes. Methods: This retrospective cross-sectional study enrolled 285 inpatients with type 2 diabetes. The lateral view of an abdominal X-ray image obtained while each subject was in a standing position was examined, and the AAC score and AAC length, corresponding to the area of calcific deposits in the anterior and posterior aortic wall for the L1-4 and L1-5 regions, respectively, were measured. The associations between the AAC scores and lengths and the presence of coronary artery disease (CAD), cerebral infarction (CI), and peripheral artery disease (PAD) were then assessed. The correlation between the AAC grades and other clinical factors were also evaluated. Results: The degree of AAC was significantly correlated with a higher prevalence of CAD and CI but not PAD after adjustments for cardiovascular risk factors. The AAC score was inversely correlated with BMI, and both the AAC score and the AAC length were correlated with the Fib-4 index; these correlations persisted after adjustments for cardiovascular risk factors and BMI, although AAC was not associated with ultrasonography-diagnosed fatty liver. Conclusion: AAC is associated with CAD and CI morbidity in patients with type 2 diabetes. AAC grading also predicts the Fib-4 index, a hepatic fibrosis marker, suggesting a novel potential predictor of liver disease that is independent of cardiovascular risk factors and obesity.
Relationships between obesity, glycemic control, and cardiovascular risk factors: a pooled analysis of cross-sectional data from Spanish patients with type 2 diabetes in the preinsulin stage
