New light on association between diabetes and heart valve di
Incidence for valvular outcomes is increasing among patients with diabetes and the general population. Researchers included 715,143 patients with diabetes registered in the Swedish National Diabetes Register and compared them with 2,732,333 matched controls randomly selected from the general population. In type 2 diabetes, systolic blood pressure, body mass index and renal function was associated with valvular lesions. Hazard ratios for patients with type 2 diabetes who had nearly all risk factors within target rages, compared with controls, were as follows: aortic stenosis 1.34 (95% CI, 1.31 to 1.38), aortic regurgitation 0.67 (95% CI, 0.64 to 0.70), mitral stenosis 1.95 (95% CI, 1.76 to 2.20), and for mitral regurgitation 0.82 (95% CI, 0.79 to 0.85). Hazard ratios for patients with type 1 diabetes and nearly optimal risk factor control, were as follows: aortic stenosis 2.01 (95% CI, 1.58 to 2.56), aortic regurgitation 0.63 (95% CI, 0.43 to 0.94) and mitral stenosis 3.47 (95% CI, 1.37 to 8.84). Excess risk in patients with type 2 diabetes for stenotic lesions showed hazard ratio for aortic stenosis 1.62 (95% CI, 1.59 to 1.65), mitral stenosis 2.28 (95% CI, 2.08 to 2.50), type 1 diabetes showed 2.59 (95% CI, 2.21 to 3.05) and 11.43 (95% CI, 6.18 to 21.15), respectively. Risk for aortic- and mitral regurgitation was lower in type 2 diabetes; 0.81 (95% CI, 0.78 to 0.84) and 0.95 (95% CI, 0.92 to 0.98), respectively.

Individuals with type 1 and 2 diabetes have greater risk for stenotic lesions, whereas risk for valvular regurgitation was lower in type 2 diabetes. Patients with well-controlled cardiovascular risk factors continued to display higher risk for valvular stenosis, without a clear stepwise decrease in risk between various degrees of risk factor control.

Source: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.058072
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