Moderate-to-vigorous physical activity does not improve mortality in type 2 diabetes patients with severe abdominal aortic calcification

PLoS One. 2025 Jan 9;20(1):e0317007. doi: 10.1371/journal.pone.0317007. eCollection 2025.

Abstract

Background: The impact of moderate-to-vigorous physical activity (MVPA) on all-cause mortality in type 2 diabetes (T2D) patients with severe abdominal aortic calcification (SAAC) remains unclear.

Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014, including T2D patients aged 40 years and older. AAC was assessed using the Kauppila scoring system, with SAAC defined as a score >6. Self-reported MVPA was categorized based on weekly minutes of activity. The weighted Cox regression model was used to investigate risk associations.

Results: Among the weighted sample of 20,328,606 T2D participants, 16.39% had SAAC. SAAC was significantly associated with increased all-cause mortality (HR 2.57, 95% CI 1.52-4.35) after adjusting for confounders. MVPA did not significantly reduce mortality risk in patients with SAAC (HR 1.00, 95% CI 0.40-2.49).

Conclusion: SAAC is a robust predictor of mortality in T2D patients, and MVPA does not improve mortality outcomes in this high-risk group. Future studies should conduct more detailed subgroup analyses to identify the specific indications for MVPA.

MeSH terms

  • Adult
  • Aged
  • Aorta, Abdominal* / pathology
  • Aortic Diseases / mortality
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / mortality
  • Exercise*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Proportional Hazards Models
  • Risk Factors
  • Vascular Calcification* / mortality