Periaortic fat deposition is associated with peripheral arterial disease: the Framingham heart study.
BACKGROUND
Central obesity is associated with peripheral arterial disease, suggesting that ectopic fat depots may be associated with localized diseases of the aorta and lower-extremity arteries. We hypothesized that persons with greater amounts of periaortic fat are more likely to have clinical PAD and a low ankle-brachial index.


RESULTS
We quantified periaortic fat surrounding the thoracic aorta using a novel volumetric quantitative approach in 1205 participants from the Framingham Heart Study Offspring cohort (mean age, 65.9 years; women, 54%); visceral abdominal fat also was measured. Clinical peripheral arterial disease was defined as a history of intermittent claudication, and ankle-brachial index was dichotomized as low ( ≤ 0.9) or lower-extremity revascularization versus normal (> 0.9 to < 1.4). Regression models were created to examine the association between periaortic fat and intermittent claudication or low ankle-brachial index (n = 66). In multivariable logistic regression, per 1 SD increase in periaortic fat, the odds ratio for the combined end point was 1.52 (P = 0.004); these results were strengthened with additional adjustment for body mass index (odds ratio, 1.69; P = 0.002) or visceral abdominal fat (odds ratio, 1.67; P = 0.009), whereas no association was observed for visceral abdominal fat (P = 0.16). Similarly, per SD increase in body mass index or waist circumference, no association was observed after accounting for visceral abdominal fat (body mass index, P = 0.35; waist circumference, P=0.49).


CONCLUSIONS
Periaortic fat is associated with low ABI and intermittent claudication.
Fox
Caroline S
CS
National Heart, Lung, and Blood Institute Framingham Heart Study, Bethesda, MD, USA. foxca@nhlbi.nih.gov
Massaro
Joseph M
JM
Schlett
Christopher L
CL
Lehman
Sam J
SJ
Meigs
James B
JB
O'Donnell
Christopher J
CJ
Hoffmann
Udo
U
Murabito
Joanne M
JM
D050153:Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D050154:Adiposity; D000368:Aged; D055109:Ankle Brachial Index; D001013:Aorta, Thoracic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed