{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:11:45Z","timestamp":1787242305240,"version":"build-2736575974"},"reference-count":45,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Vascular calcification is a frequent consequence of ageing and is associated with an increased risk of cardiovascular disease. This study aimed to compare two rapid scoring systems for quantifying calcification of the distal abdominal aorta and iliac arteries and to investigate correlations with increasing age. Methods: Patients aged \u226565 years who sustained pelvic trauma between 2003 and 2023 and underwent computed tomography (CT) were included in this retrospective study. Patients were categorised into three age groups (65\u201374, 75\u201384, \u226585). The abdominal aorta calcification score (AACS) and the common, external, and total iliac artery calcification scores (CIACS, EIACS, TIACS) were assessed on cross-sectional images and classified into three severity grades (mild, moderate, severe). Results: A total of 224 patients (mean age 78.8 \u00b1 8.5 years; 62% female) were included. Significant differences between age groups were identified for hypertension (p &lt; 0.001), osteoporosis (p &lt; 0.001), atrial fibrillation (p = 0.015), chronic heart failure (p = 0.004), chronic kidney disease (p &lt; 0.001), neurocognitive disorders (p &lt; 0.001), and anticoagulant therapy (p = 0.002). Calcification severity increased with age across all vascular territories (EIACS p = 0.006; others p &lt; 0.001). In multivariable linear regression, age remained the strongest adjusted predictor of calcification across all vascular regions (\u03b2 = 0.323\u20130.376, all p &lt; 0.001). Significant positive correlations were found between aortic and iliac calcifications (all p &lt; 0.001), strongest between AACS and CIACS (\u03c1 = 0.78, CI 0.719\u20130.835) and TIACS (\u03c1 = 0.745, CI 0.676\u20130.807). Corresponding categorical associations were most pronounced between AACS and CIACS. Conclusions: The evaluated calcification scores were strongly correlated and demonstrated clear age-dependent trends. Given their simplicity and applicability to routine CT imaging, these methods may provide practical tools for assessing vascular ageing.<\/jats:p>","DOI":"10.3390\/diagnostics15243151","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T08:39:18Z","timestamp":1765442358000},"page":"3151","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vascular Calcification Patterns in the Elderly: Correlation Between Aortic and Iliac Calcification Burden"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8141-8006","authenticated-orcid":false,"given":"Maximilian","family":"Lutz","sequence":"first","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6577-0784","authenticated-orcid":false,"given":"Malik","family":"Galijasevic","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Lindtner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7031-2718","authenticated-orcid":false,"given":"Andreas E.","family":"Ellmerer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4548-485X","authenticated-orcid":false,"given":"David","family":"Wippel","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6859-8377","authenticated-orcid":false,"given":"Elke R.","family":"Gizewski","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5790-2724","authenticated-orcid":false,"given":"Stephanie","family":"Mangesius","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Krappinger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5179-2309","authenticated-orcid":false,"given":"Alexander","family":"Loizides","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/joim.12605","article-title":"Arterial ageing: From endothelial dysfunction to vascular calcification","volume":"281","author":"Tesauro","year":"2017","journal-title":"J. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/MOL.0000000000000703","article-title":"Age-associated arterial calcification: The current pursuit of aggravating and mitigating factors","volume":"31","author":"Chakrabarti","year":"2020","journal-title":"Curr. Opin. Lipidol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1161\/ATVBAHA.113.302070","article-title":"Inflammatory, metabolic, and genetic mechanisms of vascular calcification","volume":"34","author":"Demer","year":"2014","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1161\/ATVBAHA.118.311576","article-title":"Multifaceted Mechanisms of Vascular Calcification in Aging","volume":"39","author":"Pescatore","year":"2019","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lee, S.J., Lee, I.K., and Jeon, J.H. (2020). Vascular Calcification-New Insights into Its Mechanism. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21082685"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1038\/s41392-025-02346-0","article-title":"Arterial stiffness and vascular aging: Mechanisms, prevention, and therapy","volume":"10","author":"Herzog","year":"2025","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e031146","DOI":"10.1161\/JAHA.123.031146","article-title":"Associations Between Life\u2019s Essential 8 and Abdominal Aortic Calcification Among Middle-Aged and Elderly Populations","volume":"12","author":"Cai","year":"2023","journal-title":"J. Am. Heart Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.amjcard.2012.05.020","article-title":"Prevalence and distribution of abdominal aortic calcium by gender and age group in a community-based cohort (from the Framingham Heart Study)","volume":"110","author":"Chuang","year":"2012","journal-title":"Am. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1161\/01.ATV.0000110786.02097.0c","article-title":"Patterns and risk factors for systemic calcified atherosclerosis","volume":"24","author":"Allison","year":"2004","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1161\/ATVBAHA.117.310490","article-title":"Prevalence of Calcification in Human Femoropopliteal Arteries and its Association with Demographics, Risk Factors, and Arterial Stiffness","volume":"38","author":"Kamenskiy","year":"2018","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"H2313","DOI":"10.1152\/ajpheart.00040.2021","article-title":"Calcification prevalence in different vascular zones and its association with demographics, risk factors, and morphometry","volume":"320","author":"Jadidi","year":"2021","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1093\/aje\/kwm091","article-title":"A comparison of risk factors for calcified atherosclerotic plaque in the coronary, carotid, and abdominal aortic arteries: The diabetes heart study","volume":"166","author":"Wagenknecht","year":"2007","journal-title":"Am. J. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Chen, S., Li, N., Gao, Y., Jiang, H., and Shen, Y. (2022). Prevalence and risk factors for vascular calcification based on the ankle-brachial index in the general population: A cross-sectional study. BMC Cardiovasc. Disord., 22.","DOI":"10.1186\/s12872-022-02668-9"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1161\/CIRCULATIONAHA.105.580696","article-title":"Distribution of coronary artery calcium by race, gender, and age: Results from the Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"113","author":"McClelland","year":"2006","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1161\/HYPERTENSIONAHA.109.147520","article-title":"Blood pressure and vascular calcification","volume":"55","author":"Jensky","year":"2010","journal-title":"Hypertension"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"248","DOI":"10.4082\/kjfm.17.0098","article-title":"Relationship between Smoking and Abdominal Aorta Calcification on Computed Tomography","volume":"40","author":"Jung","year":"2019","journal-title":"Korean J. Fam. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.atherosclerosis.2016.10.036","article-title":"Associations of cardiovascular disease risk factors with abdominal aortic calcium volume and density: The Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"255","author":"Forbang","year":"2016","journal-title":"Atherosclerosis"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1161\/CIRCRESAHA.121.318061","article-title":"Arterial stiffness and cardiovascular risk in hypertension","volume":"128","author":"Boutouyrie","year":"2021","journal-title":"Circ. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2938","DOI":"10.1161\/CIRCULATIONAHA.107.743161","article-title":"Vascular calcification: Pathobiology of a multifaceted disease","volume":"117","author":"Demer","year":"2008","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1161\/01.HYP.0000236599.91051.1e","article-title":"Increased ambulatory arterial stiffness index is associated with target organ damage in primary hypertension","volume":"48","author":"Leoncini","year":"2006","journal-title":"Hypertension"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"185","DOI":"10.2147\/VHRM.S4822","article-title":"Vascular calcifications as a marker of increased cardiovascular risk: A meta-analysis","volume":"5","author":"Rennenberg","year":"2009","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e017205","DOI":"10.1161\/JAHA.120.017205","article-title":"Prognostic Value of Abdominal Aortic Calcification: A Systematic Review and Meta-Analysis of Observational Studies","volume":"10","author":"Leow","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1016\/j.jvs.2022.07.001","article-title":"Aortic calcification index predicts mortality and cardiovascular events in operatively treated patients with peripheral artery disease: A prospective PURE ASO cohort follow-up study","volume":"76","author":"Rantasalo","year":"2022","journal-title":"J. Vasc. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.jvs.2023.02.019","article-title":"Iliac artery calcification score stratifies mortality risk estimation in patients with chronic limb-threatening ischemia undergoing revascularization","volume":"78","author":"Huynh","year":"2023","journal-title":"J. Vasc. Surg."},{"key":"ref_25","first-page":"e15561","article-title":"Measurement of Aortic Atherosclerotic Disease Severity: A Novel Tool for Simplified, Objective Disease Scoring Using CT Angiography","volume":"13","author":"Reddy","year":"2021","journal-title":"Cureus"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"436","DOI":"10.2214\/AJR.15.14794","article-title":"Application of a Novel CT-Based Iliac Artery Calcification Scoring System for Predicting Renal Transplant Outcomes","volume":"206","author":"Davis","year":"2016","journal-title":"Am. J. Roentgenol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Fornasari, A., Kuntz, S., Martini, C., Perini, P., Cabrini, E., Freyrie, A., Lejay, A., and Chakf\u00e9, N. (2024). Objective Methods to Assess Aorto-Iliac Calcifications: A Systematic Review. Diagnostics, 14.","DOI":"10.3390\/diagnostics14101053"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0021-9150(97)00106-8","article-title":"New indices to classify location, severity and progression of calcific lesions in the abdominal aorta: A 25-year follow-up study","volume":"132","author":"Kauppila","year":"1997","journal-title":"Atherosclerosis"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.jocd.2006.05.007","article-title":"Detection of abdominal aortic calcification with lateral spine imaging using DXA","volume":"9","author":"Schousboe","year":"2006","journal-title":"J. Clin. Densitom."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/j.ijcard.2016.06.064","article-title":"Comparing different calcification scores to detect outcomes in chronic kidney disease patients with vascular calcification","volume":"220","author":"NasrAllah","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Goorani, S., Zangene, S., and Imig, J.D. (2024). Hypertension: A continuing public healthcare issue. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26010123"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e519","DOI":"10.1212\/WNL.0000000000010022","article-title":"Twenty-seven-year time trends in dementia incidence in Europe and the United States: The Alzheimer Cohorts Consortium","volume":"95","author":"Wolters","year":"2020","journal-title":"Neurology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, regional, and national burden of chronic kidney disease, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"395","author":"Bikbov","year":"2020","journal-title":"Lancet"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1136\/heartjnl-2021-320131","article-title":"Prevalence, incidence and survival of heart failure: A systematic review","volume":"108","author":"Johnson","year":"2022","journal-title":"Heart"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e2255838","DOI":"10.1001\/jamanetworkopen.2022.55838","article-title":"Prevalence and Incidence of Atrial Fibrillation Among Older Primary Care Patients","volume":"6","author":"Khurshid","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1186\/s13018-021-02821-8","article-title":"Global prevalence of osteoporosis among the world older adults: A comprehensive systematic review and meta-analysis","volume":"16","author":"Salari","year":"2021","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1161\/01.CIR.96.1.308","article-title":"Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study","volume":"96","author":"Franklin","year":"1997","journal-title":"Circulation"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.numecd.2024.01.031","article-title":"Associations between bone mineral density and abdominal aortic calcification: Results of a nationwide survey","volume":"34","author":"Wei","year":"2024","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3413","DOI":"10.1007\/s11010-025-05210-5","article-title":"The bone-vascular axis: The link between osteoporosis and vascular calcification","volume":"480","author":"Sun","year":"2025","journal-title":"Mol. Cell. Biochem."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Siracusa, C., Carabetta, N., Morano, M.B., Manica, M., Strangio, A., Sabatino, J., Leo, I., Castagna, A., Cianflone, E., and Torella, D. (2024). Understanding Vascular Calcification in Chronic Kidney Disease: Pathogenesis and Therapeutic Implications. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms252313096"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.yjmcc.2019.12.006","article-title":"Oxidative stress contributes to vascular calcification in patients with chronic kidney disease","volume":"138","author":"Huang","year":"2020","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Dube, P., DeRiso, A., Patel, M., Battepati, D., Khatib-Shahidi, B., Sharma, H., Gupta, R., Malhotra, D., Dworkin, L., and Haller, S. (2021). Vascular Calcification in Chronic Kidney Disease: Diversity in the Vessel Wall. Biomedicines, 9.","DOI":"10.3390\/biomedicines9040404"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.avsg.2020.04.018","article-title":"Low Iliofemoral Calcium Score May Predict Higher Survival after EVAR and FEVAR","volume":"68","author":"Vaccarino","year":"2020","journal-title":"Ann. Vasc. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.atherosclerosis.2017.01.029","article-title":"Calcification of the splenic, iliac, and breast arteries and risk of all-cause and cardiovascular mortality","volume":"259","author":"Hendriks","year":"2017","journal-title":"Atherosclerosis"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Sheng, C., Cai, Z., and Yang, P. (2025). Association of the abdominal aortic calcification with all-cause and cardiovascular disease-specific mortality: Prospective cohort study. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0314776"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/24\/3151\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T08:51:35Z","timestamp":1765443095000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/24\/3151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,11]]},"references-count":45,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["diagnostics15243151"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15243151","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,11]]}}}