• Joana Ferreira Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • Jacinta Campos
  • Sandrina Braga
  • Pedro Sousa
  • João Simões
  • Celso Carrilho
  • Alexandra Canedo
  • Amílcar Mesquita




Objective/Background: Peripheral artery disease (PAD) is an important manifestation of systemic atherosclerosis. Obesity is a risk factor for atherosclerosis and for cardiovascular events. However, the relationship between obesity and PAD is unclear. We hypothesized that anthropometric measures of adiposity, in particularly of central obesity will be associated with PAD severity, in patients undergoing aorto-bifemoral bypass.

Methods: A prospective observation study was conducted. From 2009 and 2012 a total of 46 males who underwent aorto-bifemoral bypass were enrolled prospectively. 17 with intermittent claudication (IC) and 29 with chronic limb threatening ischemia (CLTI). They were followed for 5 years. The anthropometric measures, weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and the seric levels of hemoglobin, triglycerides, and albumin were recorded. The mortality and cardiovascular events in following five years were also registered.

Results: The groups did not differ in the mean age (IC 60.69±7.46 versus CLTI 64.51 ±8.42 years, p=0.712), diabetes (IC 18% versus CLTI 45%, p=0.06), hypertension (IC 70% versus CLTI 52%, p=0.21), hypercholesterolemia (IC 18% versus CLTI 45%, p=0.47) and smoking habits prevalence (IC 100% versus CLTI 86%, p=0.11). The anthropometric measures: weight, WC and WHR were significant lower in CLTI compared to IC patients (IC 72.74±9.84 Kg versus CLTI 65.92±10.89 Kg, p=0.043; IC 98.65±8.19 cm versus CLTI 89.38±15.91 cm, p=0.017; IC 1.06±0.06 versus CLTI 1.01±0.06, p=0.038). The serum levels of hemoglobin, albumin and triglycerides were also lower in CLTI patients (IC 14,40±1.63g/dL versus CLTI 13.3±1.89g/dL, p=0.048; IC 4.6±0.81g/dL versus CLTI 4.3± 0.67g/dL, p=0.007; IC 212±95.60mg/Dl versus CLTI 111±41.53 mg/dL, p=0.001). No relation was found between the anthropometric measures at admission and the cardiovascular events or mortality at five years.

Conclusion: CLTI patients had lower anthropometric measures of obesity, when compared to IC patients. These results could be explained by the fact that CLTI patients with severe atherosclerotic disease are in a state of chronic inflammation, with consequent cardiometabolic demands and catabolism.


Download data is not yet available.


Dieplinger B, Poelz W, Haltmayer M, Mueller T. Hypoadiponectinemia is associated with symptomatic atherosclerotic peripheral arterial disease. Clin Chem Lab Med. 2006;44(7):830-833. doi:10.1515/CCLM.2006.145

Lu B, Zhou J, Waring ME, Parker DR, Eaton CB. Abdominal obesity and peripheral vascular disease in men and women : A comparison of waist-to-thigh ratio and waist circumference as measures of abdominal obesity. 2010;208:253-257. doi:10.1016/j.atherosclerosis.2009.06.027

Jakovljević B, Stojanov V, Lović D, Paunović K, Radosavljević V, Tutić I. Obesity and fat distribution as predictors of aortoiliac peripheral arterial disease in middle-aged men. Eur J Intern Med. 2011;22(1):84-88. doi:10.1016/j.ejim.2010.07.019

Giugliano G, Brevetti G, Laurenzano E, Brevetti L, Luciano R, Chiariello M. The prognostic impact of general and abdominal obesity in peripheral arterial disease. Int J Obes. 2010;34(2):280-286. doi:10.1038/ijo.2009.244

Fox CS, Massaro JM, Schlett CL, et al. Periaortic fat deposition is associated with peripheral arterial disease: The framingham heart study. Circ Cardiovasc Imaging. 2010;3(5):515-519. doi:10.1161/CIRCIMAGING.110.958884

Cronin O, Bradshaw B, Iyer V, et al. The Association of Visceral Adiposity with Cardiovascular Events in Patients with Peripheral Artery Disease. 2013;8(12). doi:10.1371/journal.pone.0082350

Brouwer BG, Visseren FLJ, Stolk RP, et al. Abdominal Fat and Risk of Coronary Heart Disease in Patients with Peripheral Arterial Disease. 2007;15(6):1623-1630.

Vlek ALM, Graaf Y Van Der, Sluman MA, Moll FL, Visseren FLJ, Group S. Metabolic syndrome and vascular risk in patients with peripheral arterial occlusive disease. YMVA. 50(1):61-69. doi:10.1016/j.jvs.2008.12.070

Kumakura H, Kanai H, Aizaki M, et al. The influence of the obesity paradox and chronic kidney disease on long-term survival in a Japanese cohort with peripheral arterial disease. J Vasc Surg. 2010;52(1):110-117. doi:10.1016/j.jvs.2010.02.008

Planas a, Clará a, Pou JM, et al. Relationship of obesity distribution and peripheral arterial occlusive disease in elderly men. Int J Obes Relat Metab Disord. 2001;25(7):1068-1070. doi:10.1038/sj.ijo.0801638

Golledge J, Cronin O, Iyer V, Bradshaw B, Moxon J V, Cunningham MA. Body mass index is inversely associated with

mortality in patients with peripheral vascular disease. Atherosclerosis. 2013;229(2):549-555. doi:10.1016/j.atherosclerosis.2013.04.030

Kuijk J Van, Flu W, Galal W, Chonchol M. The influence of polyvascular disease on the obesity paradox in vascular surgery patients. YMVA. 53(2):399-406. doi:10.1016/j.jvs.2010.08.048

Gaal LF Van, Mertens IL, Block CE De. Mechanisms linking obesity with cardiovascular disease. 2006;444(December):875-880. doi:10.1038/nature05487

Hung P, Tsai H, Lin C, Hung K. Abdominal Obesity Is Associated with Peripheral Artery Disease in Hemodialysis Patients. 2013;8(6):4-9. doi:10.1371/journal.pone.0067555

Cronin O., Bradshaw B., Iyer V. b c, et al. The association of visceral adiposity with cardiovascular events in patients with

peripheral artery disease. PLoS One. 2013;8(12):316-323. doi:10.1371/journal.pone.0082350

Giusti V. Management of Obesity in Patients with Peripheral Arterial Disease. 2007;582:576-582. doi:10.1016/j.ejvs.2007.05.005

Perelas A, Safarika V, Vlachos IS, et al. Correlation between mesenteric fat thickness and serum apolipoproteins in patients with peripheral arterial occlusive disease. Lipids Health Dis. 2012;11(1):1. doi:10.1186/1476-511X-11-125

Kanhai DA, Kappelle LJ, Graaf Y Van Der, Uiterwaal C, Visseren FLJ. The risk of general and abdominal adiposity in the occurrence of new vascular events and mortality in patients with various manifestations of vascular disease. 2011;36(5):695-702. doi:10.1038/ijo.2011.115

Ohnishi H, Sawayama Y, Furusyo N, Maeda S, Tokunaga S. Risk Factors for and the Prevalence of Peripheral Arterial Disease and its Relationship to Carotid Atherosclerosis : The Kyushu and Okinawa Population Study ( KOPS ). 2009:8-11.

Senda K, Miura T, Minamisawa M, et al. Predictive Value of Underweight Status for Patients With Peripheral Artery Disease With Claudication. 2017. doi:10.1177/0003319717736627

Shiraki T, Iida O, Takahara M, et al. The Geriatric Nutritional Risk Index is Independently Associated with Prognosis in Patients with Critical Limb Ischemia Following Endovascular Therapy. Eur J Vasc Endovasc Surg. 2016;52(2):218-224. doi:10.1016/j.ejvs.2016.05.016

Shah M, Martin A, Myers B, Macsweeney S, Richards T. Recognising anaemia and malnutrition in vascular patients with critical limb ischaemia RECOGNISING ANAEMIA AND MALNUTRITION IN VASCULAR. 2010:495-498. doi:10.1308/003588410X12664192075738

Salomon L, Leclerc B, Morgant M, et al. SC. Ann Vasc Surg. 2017. doi:10.1016/j.avsg.2017.04.030

Manuscript A. NIH Public Access. 2010;14(4):381-392. doi:10.1177/1358863X09106869.Novel

Teperman J, Carruthers D, Guo Y, et al. Relationship between neutrophil-lymphocyte ratio and severity of lower extremity peripheral artery disease. Int J Cardiol. 2017;228:201-204. doi:10.1016/j.ijcard.2016.11.097

Murata N. Complex Relationship of Body Mass Index with Mortality in Patients with Critical Limb Ischemia Undergoing Endovascular Treatment. Eur J Vasc Endovasc Surg. 2014. doi:10.1016/j.ejvs.2014.10.014

Cronin O, Morris DR, Walker PJ, Golledge J. The association of obesity with cardiovascular events in patients with peripheral artery disease. Atherosclerosis. 2013;228(2):316-323. doi:10.1016/j.atherosclerosis.2013.03.002




How to Cite

Ferreira J, Campos J, Braga S, Sousa P, Simões J, Carrilho C, Canedo A, Mesquita A. DIFFERENCES IN ANTHROPOMETRIC MEASURES BETWEEN CRITICAL LIMB THREATENING ISCHAEMIA AND INTERMITTENT CLAUDICATION IN PATIENTS UNDERGOING AORTO-BIFEMORAL BYPASS. Rev Port Cir Cardiotorac Vasc [Internet]. 2020 Jun. 30 [cited 2024 May 22];27(2):111-6. Available from: https://pjctvs.com/index.php/journal/article/view/58



Original Articles

Most read articles by the same author(s)

1 2 > >>