Dysglycaemia and the risk of incident aortic valve disease: A population-based cohort study

This study evaluates the association between fasting glucose levels and the risk of incident aortic valve disease (AVD) in a large population-based cohort. This retrospective cohort study included 11,905 adults, excluding individuals with prior valve disease, missing data, or under 18 years of age. Participants were stratified by fasting glucose into low, normal, impaired fasting glucose (IFG), high glucose, and diagnosed diabetes categories. The primary outcome was incident AVD over long-term follow-up. Cox proportional hazards models adjusted for demographic and cardiovascular risk factors were used, supplemented by restricted cubic spline and age-stratified analyses. A total of 593 cases of AVD occurred among 11,905 participants during follow-up. IFG (hazard ratio 1.28, 95% confidence interval: 1.03-1.59) and diagnosed diabetes (hazard ratio 1.61, 95% confidence interval: 1.18-2.19) were significantly associated with increased risk. Spline analysis revealed a threshold effect above 5.5 mmol/L. Case-control comparisons showed persistently higher baseline glucose in cases. Kaplan-Meier curves demonstrated lowest event-free survival in diabetes and IFG groups. Even modest elevations in fasting glucose are associated with a significantly increased risk of AVD.