Association between gait characteristics and endothelial oxidative stress and inflammation in patients with symptomatic peripheral artery disease.
The aim of the study was to determine whether gait characteristics were associated with endothelial cell inflammation, oxidative stress, and apoptosis and with circulating biomarkers of inflammation and antioxidant capacity in older patients with symptomatic peripheral artery disease (PAD). Gait measurements of 231 symptomatic men and women with PAD were assessed during a 4-m walk test. Patients were further characterized on endothelial effects of circulating factors present in the sera using a cell culture-based bioassay on primary human arterial endothelial cells and on circulating inflammatory and vascular biomarkers. In a multivariate regression model for gait speed, the significant independent variables were age (p < 0.001), intercellular cell adhesion molecule-1 (ICAM-1) (p < 0.001), diabetes (p = 0.003), sex (p = 0.003), and history of cerebrovascular accidents (p = 0.021). In multivariate analyses for gait cadence, the significant independent predictors included high-sensitivity C-reactive protein (HsCRP) (p < 0.001), diabetes (p = 0.001), and hypertension (p = 0.001). In a multivariate regression model for gait stride length, the significant independent variables were HsCRP (p < 0.001), age (p < 0.001), ICAM-1 (p < 0.001), hypertension (p = 0.002), cellular reactive oxygen species production (p = 0.007), and sex (p = 0.008). Higher levels of circulating biomarkers of inflammation and endothelial cell oxidative stress were associated with slower gait speed, slower cadence, and shorter stride length in older symptomatic patients with PAD. Additionally, this profile of impaired gait was more evident in older patients, in women, and in those with diabetes, hypertension, and history of cerebrovascular accidents.
Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), 1122 N.E. 13th Street, O'Donoghue Research Building, Suite 1200, Oklahoma City, OK, 73117, USA. andrew-gardner@ouhsc.edu.|Veterans Affairs Medical Center, Oklahoma City, OK, USA. andrew-gardner@ouhsc.edu.
Andrew W
AW
Gardner
Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), 1122 N.E. 13th Street, O'Donoghue Research Building, Suite 1200, Oklahoma City, OK, 73117, USA.
Polly S
PS
Montgomery
Cardiovascular Section, Department of Medicine, OUHSC, Oklahoma City, OK, USA.
Ana I
AI
Casanegra
Cardiovascular Section, Department of Medicine, OUHSC, Oklahoma City, OK, USA.
Federico
F
Silva-Palacios
Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), 1122 N.E. 13th Street, O'Donoghue Research Building, Suite 1200, Oklahoma City, OK, 73117, USA.
Zoltan
Z
Ungvari
Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), 1122 N.E. 13th Street, O'Donoghue Research Building, Suite 1200, Oklahoma City, OK, 73117, USA.
Anna
A
Csiszar
D000368:Aged; D017209:Apoptosis; D015415:Biomarkers / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D008297:Male; D018384:Oxidative Stress; D058729:Peripheral Arterial Disease / Q000378:metabolism / Q000503:physiopathology*; D017382:Reactive Oxygen Species / Q000378:metabolism*
D015415:Biomarkers; D017382:Reactive Oxygen Species
Claudication; Gait speed; Inflammation; Mobility; Oxidative stress