Obesity and fat distribution as predictors of aortoiliac peripheral arterial disease in middle-aged men.
BACKGROUND
Peripheral arterial disease (PAD) in the aortoiliac segment is found in nearly a half of patients with PAD. The aim of this study was to estimate the influence of obesity and fat distribution on the occurrence of aortoiliac PAD in middle-aged men.


METHODS
This case-control study included 204 middle-aged men (mean 58±7 years; range 45-70 years): 102 patients with aortoiliac PAD and 102 healthy controls without PAD. Aortoiliac PAD was diagnosed by ankle-brachial index (ABI) and angiography. Body mass index (BMI) was categorized as: normal weight, overweight, and obese. Percents of body fat were grouped according to quartile distribution. The relationship between anthropometrics and aortoiliac PAD was estimated by multivariate logistic regression.


RESULTS
Patients with aortoiliac PAD had higher body mass index, waist circumference, waist-hip ratio and percent of body fat. A strong correlation between all anthropometric parameters and ABI index and mean angiographic score was shown among patients with PAD. Multivariate regression, adjusted for blood pressure and cholesterol level, identified being overweight, body fat over 26.5% and WHR over 1.02 as predictors for aortoiliac PAD. Body fat over 26.5% and WHR over 1.02 remained significant after further adjustment for blood pressure, cholesterol and body mass index.


CONCLUSIONS
This study has identified the quantity of fat tissue (body fat over 26.5%) and its visceral distribution (waist-hip ratio over 1.02) as predictors of aortoiliac PAD in middle-aged men. Body mass index, a crude indicator of obesity, should be combined with these parameters when assessing the risk for aortoiliac PAD.
Institute for Hygiene and Medical Ecology, School of Medicine, University of Belgrade, Belgrade, Serbia. bra@beotel.net
Branko
B
Jakovljević
Vesna
V
Stojanov
Dragan
D
Lović
Katarina
K
Paunović
Vladan
V
Radosavljević
Izet
I
Tutić
D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology*; D050218:Body Fat Distribution; D015992:Body Mass Index; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D006801:Humans; D007083:Iliac Artery / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000209:etiology*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D049629:Waist-Hip Ratio