Joint association between FIB-4 index and advanced cardiovascular-kidney-metabolic syndrome with aortic valve calcification: a community cohort in China

BACKGROUND AND AIMS: Aortic valve calcification (AVC) is common during the process of ageing. Based on available research, liver fibrosis, cardiovascular risk factors and impaired kidney function have been associated with AVC. This study aimed to analyse the relationship between fibrosis-4 (FIB-4) index and advanced Cardiovascular-Kidney-Metabolic (CKM) syndrome with AVC respectively and their joint effects on AVC. METHODS: This study included 2884 participants from middle-aged and elderly Chinese population. AVC was evaluated by echocardiography and advanced CKM syndrome was defined by standard guidelines. We assessed associations between FIB-4 index, advanced CKM syndrome and AVC using logistic regression models. Combined effects were calculated by dividing the two indicators into four groups and 1.39 was the cut-off value of FIB-4 index. Subgroup analyses were performed to stratify results efficiently and investigate interaction effects in the relationships between the FIB-4 index, advanced CKM syndrome and AVC. RESULTS: Of 2884 participants, the mean age was 61.22 ± 6.66 and 45.42% were male, with 257 AVC events. After covariates adjustment, advanced CKM syndrome was significantly associated with AVC with odds ratio (OR) of 1.28(1.13-1.45). As a continuous variable, FIB-4 index correlated with AVC with OR of 2.03(1.43-2.90). As a categorical variable, FIB-4 index also was connected with AVC. The joint effects of advanced CKM syndrome and FIB-4 index showed stronger association with AVC after adjusting for variables. Furthermore, the FIB-4 index exhibited a nonlinear association with AVC. CONCLUSION: Elevated FIB-4 index and advanced CKM syndrome were both related with AVC among middle-aged and elderly populations. Moreover, the combined exposure to elevated FIB‑4 and advanced CKM syndrome conferred a stronger correlative relationship with AVC.