J Diabetes. 2026 Jun;18(6):e70247. doi: 10.1111/1753-0407.70247.
ABSTRACT
BACKGROUND: To investigate whether diabetic foot (DF) is associated with a higher prevalence and severity of coronary artery calcification (CAC) in patients with type 2 diabetes (T2DM) using low-dose computed tomography (LDCT).
METHODS: This cross-sectional study included 710 patients with DF and 1176 patients with T2DM but without DF who had undergone LDCT recruited in the Diabetic Foot Care Center of West China Hospital, Sichuan University. The severity of CAC was evaluated using a length-based grading method. The independent association between DF and CAC was evaluated using multivariable logistic regression and propensity score matching (PSM).
RESULTS: The overall prevalence of CAC among individuals with DF was 71.9%, compared to 46.1% in those without DF. DF was independently associated with CAC; an association remained statistically significant after PSM (adjusted OR 1.72; 95% CI [1.28-2.32]; p < 0.001). This association was particularly strong in patients with preserved renal function, irrespective of the presence of peripheral artery disease (PAD). In contrast, among individuals with impaired renal function, no significant differences were observed in the prevalence of mild, moderate, or severe CAC between those with DF and those without DF. However, the overall prevalence of CAC across all severity levels was higher in the renal-impaired group than in those with preserved renal function.
CONCLUSIONS: DF is independently associated with the presence and severity of CAC in patients with T2DM, particularly among those with preserved renal function, irrespective of the presence of concomitant PAD. This association is not statistically significant in individuals with impaired renal function.
PMID:42307713 | DOI:10.1111/1753-0407.70247