title: Periaortic fat deposition is associated with peripheral arterial disease: the Framingham heart study.
abstract: 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.
authors.affiliation: National Heart, Lung, and Blood Institute Framingham Heart Study, Bethesda, MD, USA. foxca@nhlbi.nih.gov
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Schlett
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Lehman
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Murabito
mesh_terms: 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