Association of Peripheral Artery Disease with Obesity: Impact of Obesity on Peripheral Artery Disease

Humaira Zakir; Habiba Aman; Amanullah Khokhar; Saboohi Irfan; Nazeer Ahmed Memon; Tabassum Almas

doi:10.54393/pjhs.v5i12.2086

Authors

Humaira Zakir Department of Medicine, Al-Tibri Medical College and Hospital, Karachi, Pakistan
Habiba Aman Department of Medicine, Al-Tibri Medical College and Hospital, Karachi, Pakistan
Amanullah Khokhar Department of Medicine, Al-Tibri Medical College and Hospital, Karachi, Pakistan
Saboohi Irfan Department of Medicine, Al-Tibri Medical College and Hospital, Karachi, Pakistan
Nazeer Ahmed Memon Department of Medicine, Al-Tibri Medical College and Hospital, Karachi, Pakistan
Tabassum Almas Department of Medicine, Al-Tibri Medical College and Hospital, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i12.2086

Keywords:

Obesity, Peripheral Artery Disease, Cardiovascular Risk, Vascular Health

Abstract

Obesity has emerged as a significant contributor to the development and progression of Peripheral Artery Disease (PAD) which has significant impact on local population as the frequency of obesity is high. Objective: To determine the association between obesity and the development of Peripheral Artery Disease in patients attending General Medicine clinics. Methods: This cross-sectional study using non-probability convenient sampling was done to investigate association of obesity on the development of peripheral artery disease for six months. The study population consisted of adult patients (aged 18 and above) attending cardiovascular and metabolic clinics at Al-Tibri Medical Hospital. Inclusion criteria included patients with PAD confirmed by ankle-brachial index (ABI) of less than 0.90 into mild, moderate and severe. Patients with acute infections, malignancies were excluded. Hypothesis of the study stated that whether there was an association between obesity and development of PAD or not. Statistical analysis done using SPSS version 23.0, involved association between BMI and PAD using chi-square tests keeping p<0.05 statistically significant. Results: The mean age of participants was 50.87 ± 8.32 years. Mean ABI was 1.02 ± 0.12. Individuals having normal BMI (18-22.99 kg/m²), 6 had PAD. In the overweight category (23-24.99 kg/m²), 8 had PAD. In the Obese I category (25-26.99 kg/m²), 11 had PAD. In the Obese II category (27-29.99 kg/m²), 20 had PAD. In the Obese III category (>30 kg/m²), 24 had PAD. A significant association between BMI and PAD was observed between both groups (p-0.01). Conclusion: A significant association between obesity and PAD development was observed in this study. Obesity was a significant factor in the development of PAD. The significant association between obesity and PAD observed in this study underscores the need for public health interventions aimed at weight management

References

Golledge J. Update on the Pathophysiology and Medical Treatment of Peripheral Artery Disease. Nature reviews cardiology. 2022 Jul; 19(7): 456-474. doi: 10.1038/s41569-021-00663-9.

Lempesis IG, Varrias D, Sagris M, Attaran RR, Altin ES, Bakoyiannis C, et al. Obesity and Peripheral Artery Disease: Current Evidence and Controversies. Current Obesity Reports. 2023 Sep; 12(3): 264-279. doi: 10.1007/s13679-023-00510-7.

Chooi YC, Ding C, Magkos F. The Epidemiology of Obesity. Metabolism. 2019 Mar; 92:6-10. doi: 10.1016/j.metabol.2018.09.005.

Keller K, Hobohm L, Geyer M, Münzel T, Lavie CJ, Ostad MA, et al. Obesity Paradox in Peripheral Artery Disease. Clinical Nutrition. 2019 Oct; 38(5): 2269-2276. doi: 10.1016/j.clnu.2018.09.031.

Heffron SP, Dwivedi A, Rockman CB, Xia Y, Guo Y, Zhong J, et al. Body Mass Index and Peripheral Artery Disease. Atherosclerosis. 2020 Jan; 292:31-6. doi: 10.1016/j.atherosclerosis.2019.10.017.

Kanegusuku H, Cucato GG, Domiciano RM, Longano P, Puech-Leao P, Wolosker N, et al. Impact of Obesity on Walking Capacity and Cardiovascular Parameters in Patients with Peripheral Artery Disease: A Cross-Sectional Study. Journal of Vascular Nursing. 2020 Jun; 38(2): 66-71. doi: 10.1016/j.jvn.2020.02.004.

Miao Y, Wang Y, Wang Y, Yan P, Chen Z, Wan Q. The Association Between Triglyceride-Glucose Index and Its Combination with Obesity Indicators and Lower Extremity Peripheral Artery Disease in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. Diabetes, Metabolic Syndrome and Obesity. 2024 Dec: 2607-2617. doi: 10.2147/DMSO.S469692.

Yadav U, Kumar N, Sarvottam K. Role of Obesity-Related Inflammation in Pathogenesis of Peripheral Artery Disease in Patients with Type 2 Diabetes Mellitus. Journal of Diabetes & Metabolic Disorders. 2023 Jun; 22(1): 175-88. doi: 10.1007/s40200-023-01221-5.

Darvall KA, Sam RC, Silverman SH, Bradbury AW, Adam DJ. Obesity and Thrombosis. European Journal of Vascular and Endovascular Surgery. 2007 Feb; 33(2): 223-33. doi: 10.1016/j.ejvs.2006.10.006.

Maksimovic M, Vlajinac H, Radak D, Marinkovic J, Maksimovic J, Jorga J. Association of Overweight and Obesity with Cardiovascular Risk Factors in Patients with Atherosclerotic Diseases. Journal of Medical Biochemistry. 2020 Jan; 39(2): 215. doi: 10.2478/jomb-2019-0027.

Li J, Yu S, Zhou W, Zhu L, Wang T, Bao H, et al. U-Shaped Association of Body Mass Index with the Risk of Peripheral Arterial Disease in Chinese Hypertensive Population. International Journal of General Medicine. 2021 Jul; 3627-3534. doi: 10.2147/IJGM.S323769.

Lin DS, Lo HY, Yu AL, Lee JK, Chien KL. Mortality Risk in Patients with Underweight or Obesity with Peripheral Artery Disease: A Meta-Analysis Including 5,735,578 Individuals. International Journal of Obesity. 2022 Aug; 46(8): 1425-1434. doi: 10.1038/s41366-022-01143-x.

Zierfuss B, Höbaus C, Herz CT, Pesau G, Koppensteiner R, Schernthaner GH. Predictive Power of Novel and Established Obesity Indices for Outcome in PAD During a Five-Year Follow-Up. Nutrition, Metabolism and Cardiovascular Diseases. 2020 Jun; 30(7): 1179-87. doi: 10.1016/j.numecd.2020.03.019.

Haider R. Peripheral Vascular Disease. Cardiology Research and Reports. 2023; 5(4). doi: 10.31579/2692-9759/104.

Bianchettin RG, Lavie CJ, Lopez-Jimenez F. Challenges in Cardiovascular Evaluation and Management of Obese Patients: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2023 Feb; 81(5): 490-504.

Acosta S, Johansson A, Drake I. Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease—A Prospective Cohort Study. Nutrients. 2021 Oct; 13(11): 3822. doi: 10.3390/nu13113822.

Aday AW and Matsushita K. Epidemiology of Peripheral Artery Disease and Polyvascular Disease. Circulation Research. 2021 Jun; 128(12): 1818-32. doi: 10.1161/CIRCRESAHA.121.318535.

Fox CS, Massaro JM, Schlett CL, Lehman SJ, Meigs JB, O'Donnell CJ, et al. Periaortic Fat Deposition Is Associated with Peripheral Arterial Disease: The Framingham Heart Study. Circulation: Cardiovascular Imaging. 2010 Sep; 3(5): 515-519. doi: 10.1161/CIRCIMAGING.110.958884.

Lin DS, Lo HY, Yu AL, Lee JK, Yang WS, Hwang JJ. A Dose-Response Association Between Body Mass Index and Mortality in Patients with Peripheral Artery Disease: A Meta-Analysis Including 5,729,272 Individuals. European Journal of Vascular and Endovascular Surgery. 2022 Mar; 63(3): 495-502. doi: 10.1016/j.ejvs.2021.11.016.

Kawai T, Autieri MV, Scalia R. Adipose Tissue Inflammation and Metabolic Dysfunction in Obesity. American Journal of Physiology-Cell Physiology. 2021 Mar; 320(3): 375-91. doi: 10.1152/ajpcell.00379.2020.

Yadav U, Kumar N, Sarvottam K. Role of Obesity-Related Inflammation in Pathogenesis of Peripheral Artery Disease in Patients with Type 2 Diabetes Mellitus. Journal of Diabetes & Metabolic Disorders. 2023 Jun; 22(1): 175-88. doi: 10.1007/s40200-023-01221-5.

Huang Y, Xu M, Xie L, Wang T, Huang X, Lv X, Chen Y, et al. Obesity and Peripheral Arterial Disease: A Mendelian Randomization Analysis. Atherosclerosis. 2016 Apr; 247: 218-24. doi: 10.1016/j.atherosclerosis.2015.12.034.

Aday AW, Everett BM. Dyslipidemia Profiles in Patients with Peripheral Artery Disease. Current Cardiology Reports. 2019 Jun; 21:1-9. doi: 10.1007/s11886-019-1129-5.

Heffron SP, Dwivedi A, Rockman CB, Xia Y, Guo Y, Zhong J, et al. Body Mass Index and Peripheral Artery Disease. Atherosclerosis. 2020 Jan; 292: 31-6. doi: 10.1016/j.atherosclerosis.2019.10.017.