Obesity, Weight Change, and Functional Decline in Peripheral Arterial Disease

Overview

Journal J Vasc Surg

Publisher Elsevier

Specialties Cardiology & Vascular Diseases
General Surgery

Date 2006 Jun 13

PMID 16765239

Citations 22

Authors

Mary M McDermott

Michael H Criqui

Luigi Ferrucci

Jack M Guralnik

Lu Tian

Kiang Liu

Philip Greenland

Jin Tan

Joseph R Schneider

Elizabeth Clark

William H Pearce

Affiliations

Soon will be listed here.

Abstract

Background: Our objectives were to determine whether obesity is associated with a greater functional decline compared with the ideal body mass index (BMI) among persons with peripheral arterial disease (PAD) and to determine the associations between weight gain and loss and functional declines in PAD. We hypothesized that baseline obesity and weight gain during follow-up would each be associated with functional declines in persons with PAD.

Methods: The design was a prospective cohort study. The subjects were 389 men and women with PAD (mean ankle-brachial index, 0.65 +/- 0.14) who were followed up prospectively for a median of 48 months. The main outcome measures were functional assessments (6-minute walk, usual- and rapid-paced 4-m walking speed, and summary performance score). Weight and height were measured at baseline and annually. Results were adjusted for age, sex, race, comorbidities, ankle-brachial index, education, leg symptoms, exercise status, depressive symptoms, pack-years of cigarette smoking, prior-year functioning, and patterns of missing data.

Results: Compared with those with a baseline BMI between 20 and 25 kg/m2, PAD participants with baseline BMI greater than 30 kg/m2 had a significantly greater average annual decline in 6-minute walk performance (-13.1 vs -26.5 m/y; P = .004), usual-paced 4-m walking velocity (-0.028 vs -0.055 m/s per year; P = .024), and fast-paced 4-m walking velocity (-0.053 vs -0.086 m/s per year; P = .012). Persons with weight gain between 5 and 10 pounds after baseline who walked for exercise regularly had significantly less decline in the 6-minute walk than persons without significant weight change who did not walk for exercise (P = .04).

Conclusions: Obesity is associated with functional decline in persons with PAD. Walking exercise may protect against functional decline in PAD persons with modest weight gain.

Citing Articles

Study Design, Rationale, and Methodology for Promote Weight Loss in Patients With Peripheral Artery Disease Who Also Have Obesity: The PROVE Trial.

Whipple M, Pfammatter A, Spring B, Rejeski W, Treat-Jacobson D, Domanchuk K J Am Heart Assoc. 2023; 12(17):e031182.

PMID: 37642035 PMC: 10547361. DOI: 10.1161/JAHA.123.031182.

The Efficacy of HGF/VEGF Gene Therapy for Limb Ischemia in Mice with Impaired Glucose Tolerance: Shift from Angiogenesis to Axonal Growth and Oxidative Potential in Skeletal Muscle.

Stafeev I I, Boldyreva M, Michurina S, Agareva M, Radnaeva A, Menshikov M Cells. 2022; 11(23).

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Healthcare Costs of Diabetes and Microvascular and Macrovascular Disease in Individuals with Incident Type 2 Diabetes Mellitus: A Ten-Year Longitudinal Study.

Visaria J, Iyer N, Raval A, Kong S, Hobbs T, Bouchard J Clinicoecon Outcomes Res. 2020; 12:423-434.

PMID: 32848433 PMC: 7428320. DOI: 10.2147/CEOR.S247498.

Associations of Weight Change With Changes in Calf Muscle Characteristics and Functional Decline in Peripheral Artery Disease.

Polonsky T, Tian L, Zhang D, Bazzano L, Criqui M, Ferrucci L J Am Heart Assoc. 2019; 8(13):e010890.

PMID: 31257970 PMC: 6662373. DOI: 10.1161/JAHA.118.010890.

Body-weight goals, trends, and weight-loss techniques among patients with peripheral arterial disease.

Addison O, Yang R, Serra M Nutr Health. 2018; 25(1):47-52.

PMID: 30582436 PMC: 6487636. DOI: 10.1177/0260106018817190.

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