Serum butyraldehyde levels are associated with abdominal aortic calcification: a population-based study.

BACKGROUND: Abdominal aortic calcification (AAC) is a strong predictor of cardiovascular morbidity but lacks effective interventions. Aldehydes, a diverse class of environmental and endogenous compounds, have been implicated in various chronic diseases, yet their individual and combined effects on vascular calcification remain unclear. METHODS: This study investigated associations between six serum aldehydes (benzaldehyde, butyraldehyde, heptanaldehyde, hexanaldehyde, isopentanaldehyde, propanaldehyde) and AAC in a nationally representative sample of US adults from the 2013-2014 NHANES. AAC was measured via lateral lumbar spine DXA, and serum aldehydes were quantified using gas chromatography-mass spectrometry. Analyses using weighted logistic regression and quantile g-computation (qgcomp) models, adjusted for demographic and metabolic confounders, revealed the associations between aldehydes and AAC. RESULTS: This study included 1208 NHANES participants. Each log₂-unit increase in butyraldehyde concentration was associated with a 36.7% lower AAC risk (adjusted OR = 0.633, 95% CI 0.436-0.930), and individuals in the highest tertile of exposure had a 46% reduced risk compared to those in the lowest tertile. After FDR correction for multiple comparisons, butyraldehyde exhibited the strongest association with AAC among the aldehydes examined (FDR-adjusted p = 0.096). None of the other aldehydes showed significant associations with AAC in fully adjusted models. In the mixture analysis, butyraldehyde also demonstrated the strongest inverse association with AAC (β = -0.442). The inverse association between butyraldehyde and AAC was more pronounced in individuals with klotho deficiency. CONCLUSION: These findings indicate that butyraldehyde is inversely associated with AAC, not only highlighting its potential role in vascular calcification but also suggesting the necessity of aldehyde-specific assessments in cardiovascular risk assessment. Besides, butyraldehyde may serve as a promising candidate for therapeutic development in high-risk populations.