Body mass index is inversely associated with mortality in patients with peripheral vascular disease

Golledge, Jonathan; Cronin, Oliver; Iyer, Vikram; Bradshaw, Barbara; Moxon, Joseph V.; Cunningham, Myles P.

doi:10.1016/j.atherosclerosis.2013.04.030

Cited by 75 publications

(97 citation statements)

References 48 publications

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“…This study was part of on-going prospective cohort investigation of peripheral vascular disease patients aimed at assessing risk predictors of peripheral vascular disease presence and outcome [15,16]. Monte-Carlo simulations suggest that a multivariate regression model is adequately powered when using 10 outcome events per degree of freedom of the predictor variable [17].…”

Section: Methodsmentioning

confidence: 99%

“…Patients with all types of peripheral vascular disease were considered for inclusion as previously described [15,18]. Inclusion criteria for the current study included a diagnosis of PAD, assessment of fasting blood glucose and at least one follow-up assessment as an in or out-patient.…”

Section: Methodsmentioning

confidence: 99%

“…Presenting complaints included asymptomatic carotid stenosis, mild lower limb or upper limb peripheral athero-thrombosis, aneurysm of the aorta or peripheral arteries, symptomatic carotid artery stenosis and critical lower limb ischaemia, as previously described [15,16,18]. …”

Section: Methodsmentioning

confidence: 99%

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Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study

Golledge

Quigley

Velu

et al. 2014

Cardiovasc Diabetol

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BackgroundPre-diabetes and untreated diabetes are common in patients with peripheral artery disease however their impact on outcome has not been evaluated. We examined the association of impaired fasting glucose, diabetes and their treatment with the presentation, mortality and requirement for intervention in peripheral artery disease patients.MethodsWe prospectively recruited 1637 patients with peripheral artery disease, measured fasting glucose, recorded medications for diabetes and categorised them by diabetes status. Patients were followed for a median of 1.7 years.ResultsAt entry 22.7% patients were receiving treatment for type 2 diabetes by oral hypoglycaemics alone (18.1%) or insulin (4.6%). 9.2% patients had non-medicated diabetes. 28.1% of patients had impaired fasting glucose (5.6-6.9 mM). Patients with non-medicated diabetes had increased mortality and requirement for peripheral artery intervention (hazards ratio 1.62 and 1.31 respectively). Patients with diabetes prescribed insulin had increased mortality (hazard ratio 1.97). Patients with impaired fasting glucose or diabetes prescribed oral hypoglycaemics only had similar outcomes to patients with no diabetes.ConclusionsNon-medicated diabetes is common in peripheral artery disease patients and associated with poor outcomes. Impaired fasting glucose is also common but does not increase intermediate term complications. Peripheral artery disease patients with diabetes requiring insulin are at high risk of intermediate term mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-014-0147-2) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study

Golledge

Quigley

Velu

et al. 2014

Cardiovasc Diabetol

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“…20 assessment of abdominal adipose volume. A protocol for CTA adipose volume measurement was designed 22 and incorporated techniques described in published literature with approaches learnt whilst performing aortic volumetric analysis. [23][24][25][26][27] Briefly, the radiographic threshold was set to the pre-defined threshold for adiposity (CH 120 HU, WH 75 HU), as illustrated in Figure 1.…”

Section: Worktation Protocolsmentioning

confidence: 99%

“…22 Intra-observer reproducibility measurements were completed three times with at least 1 week between measurement sets. Inter-observer reproducibility was completed at least 1 week after the intra-observer measurements were complete.…”

Section: Reproducibility Analysis For Adipose Volumementioning

confidence: 99%

Visceral adiposity is not associated with abdominal aortic aneurysm presence and growth

et al. 2014

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Previous studies in rodent models and patients suggest that visceral adipose could play a direct role in the development and progression of abdominal aortic aneurysm (AAA). This study aimed to assess the association of visceral adiposity with AAA presence and growth. This study was a case-control investigation of patients that did (n=196) and did not (n=181) have an AAA who presented to The Townsville Hospital vascular clinic between 2003 and 2012. Cases were patients with AAA (infra-renal aortic diameter >30 mm) and controls were patients with intermittent claudication but no AAA (infra-renal aortic diameter <30 mm). All patients underwent computed tomography angiography (CTA). The visceral to total abdominal adipose volume ratio was estimated from CTAs by assessing total and visceral adipose deposits using an imaging software program. Measurements were assessed for reproducibility by repeat assessments on 15 patients. AAA risk factors were recorded at entry. Forty-five cases underwent two CTAs more than 6 months apart to assess AAA expansion. The association of visceral adiposity with AAA presence and growth was examined using logistic regression. Visceral adipose assessment by CTA was highly reproducible (mean coefficient of variation 1.0%). AAA was positively associated with older age and negatively associated with diabetes. The visceral to total abdominal adipose volume ratio was not significantly associated with AAA after adjustment for other risk factors. Patients with a visceral to total abdominal adipose volume ratio in quartile four had a 1.63-fold increased risk of AAA but with wide confidence intervals (95% CI 0.71-3.70; p=0.248). Visceral adiposity was not associated with AAA growth. In conclusion, this study suggests that visceral adiposity is not specifically associated with AAA presence or growth although larger studies are required to confirm these findings.

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Assessment and validation of a novel angiographic scoring system for peripheral artery disease

Morris

Singh

Moxon

et al. 2017

British Journal of Surgery

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Body mass index is inversely associated with mortality in patients with peripheral vascular disease

Cited by 75 publications

References 48 publications

Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study

Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study

Visceral adiposity is not associated with abdominal aortic aneurysm presence and growth

Assessment and validation of a novel angiographic scoring system for peripheral artery disease

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