Femoral Artery Atherosclerosis Is Associated With Physical Function Across the Spectrum of the Ankle-Brachial Index: The San Diego Population Study.
Femoral Artery Atherosclerosis Is Associated With Physical Function Across the Spectrum of the Ankle-Brachial Index: The San Diego Population Study.
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DOI：
10.1161/jaha.117.005777
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发表时间：
2017-07-20
影响因子：
5.4
通讯作者：
Criqui MH
中科院分区：
文献类型：
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作者：
Wassel CL;Ellis AM;Suder NC;Barinas-Mitchell E;Rifkin DE;Forbang NI;Denenberg JO;Marasco AM;McQuaide BJ;Jenny NS;Allison MA;Ix JH;Criqui MH
踝肱指数（ABI）不足以检测早期动脉粥样硬化疾病，此时预防功能衰退的干预措施可能是最有效的。我们确定了股动脉粥样硬化与身体功能的关系，跨越ABI谱，在正常ABI范围内。2007-2011年，1103名多民族男性和女性参加了圣地亚哥人口研究，并完成了总结表现得分的所有组成部分。应用多普勒超声检查股骨浅、中膜厚度及斑块。采用Logistic回归评估股骨动脉粥样硬化与综合表现评分及其各个组成部分的关系。模型根据人口统计学、生活方式因素、合并症、血脂和肾功能进行调整。在调整后的模型中，在ABI正常范围（1.00-1.30）的参与者中，表面内膜中层厚度的最高分位数与完美总结表现得分为12的几率较低（优势比=0.56 [0.36,0.87]，P=0.009）、4米步行得分为4 （0.34 [0.16,0.73]，P=0.006）和椅子上升得分为4 （0.56 [0.34,0.94]，P=0.03）的几率较低相关。在正常范围ABI组中，斑块存在（0.53 [0.29,0.99]，P=0.04）和斑块总负担（0.61 [0.43,0.87]，P=0.006）与较差的4米步行表现相关。在所有个体中，较高的浅表中膜厚度与较低的综合表现评分相关（P=0.02）。研究结果表明，使用股动脉粥样硬化措施可能对ABI正常范围的个体有效，特别是糖尿病或有外周动脉疾病家族史的个体，当检测到可以早期干预以预防功能下降和改善生活质量时。
The ankle‐brachial index (ABI) is inadequate to detect early‐stage atherosclerotic disease, when interventions to prevent functional decline may be the most effective. We determined associations of femoral artery atherosclerosis with physical functioning, across the spectrum of the ABI, and within the normal ABI range. In 2007–2011, 1103 multiethnic men and women participated in the San Diego Population Study, and completed all components of the summary performance score. Using Doppler ultrasound, superficial and common femoral intima media thickness and plaques were ascertained. Logistic regression was used to assess associations of femoral atherosclerosis with the summary performance score and its individual components. Models were adjusted for demographics, lifestyle factors, comorbidities, lipids, and kidney function. In adjusted models, among participants with a normal‐range ABI (1.00–1.30), the highest tertile of superficial intima media thickness was associated with lower odds of a perfect summary performance score of 12 (odds ratio=0.56 [0.36, 0.87], P=0.009), and lower odds of a 4‐m walk score of 4 (0.34 [0.16, 0.73], P=0.006) and chair rise score of 4 (0.56 [0.34, 0.94], P=0.03). Plaque presence (0.53 [0.29, 0.99], P=0.04) and greater total plaque burden (0.61 [0.43, 0.87], P=0.006) were associated with worse 4‐m walk performance in the normal‐range ABI group. Higher superficial intima media thickness was associated with lower summary performance score in all individuals (P=0.02). Findings suggest that use of femoral artery atherosclerosis measures may be effective in individuals with a normal‐range ABI, especially, for example, those with diabetes mellitus or a family history of peripheral artery disease, when detection can lead to earlier intervention to prevent functional declines and improve quality of life.