Colorectal cancer screening methods: A systematic review

Elevated fasting glucose is linked to cardiovascular disease, but its relationship with aortic valve disease (AVD) is unclear. We investigated whether modest increases in fasting glucose are associated with the risk of incident AVD in a large population-based cohort.

In this retrospective cohort study, we included 11,905 adults (excluded: prior valve disease, missing data, age <18 years). Participants were categorized by fasting glucose as low, normal, impaired fasting glucose (IFG), high glucose, or diagnosed diabetes. The primary outcome was incident AVD during long-term follow-up. Cox proportional hazards models adjusted for demographic and cardiovascular risk factors were used to estimate hazard ratios (HRs). Complementary analyses included restricted cubic spline modeling to assess nonlinearity and age-stratified analyses; Kaplan-Meier curves and case-control comparisons of baseline glucose were also performed.

During follow-up, there were 593 incident AVD cases among 11,905 participants. Compared with the reference group, IFG was associated with increased AVD risk (HR: 1.28; 95% confidence interval: 1.03-1.59), and diagnosed diabetes showed a stronger association (HR: 1.61; 95% confidence interval: 1.18-2.19). Spline analysis demonstrated a threshold-like rise in risk above ~5.5 mmol/L. Case-control comparisons indicated persistently higher baseline fasting glucose in cases, and Kaplan-Meier curves showed the lowest event-free survival in the diabetes and IFG groups.

Even modest elevations in fasting glucose - beginning near 5.5 mmol/L - are associated with a significantly increased risk of incident AVD, highlighting the potential importance of early glycemic control for AVD prevention.