Dept. of Thoracic and Cardiovascular Surgery and Vascular Medicine, Dupuytren University Hospital, Limoges, France.
Atherosclerosis. 2011 Jan;214(1):169-73. doi: 10.1016/j.atherosclerosis.2010.10.011. Epub 2010 Oct 21.
Lower-extremity peripheral artery disease (LE-PAD), is strongly related to traditional risk factors (smoking, hypertension, dyslipidemia, diabetes). We hypothesized that the prevalence of LE-PAD in the absence of traditional CVD risk factors is not negligible, and that this condition would remain associated with subclinical atherosclerosis in other territories.
In the Multi-Ethnic Study of Atherosclerosis, we classified participants without any traditional risk factor according to their ankle-brachial index (ABI) into 3 groups: low (<1.00), normal (1.00-1.30) and high (>1.30) ABI. Coronary or carotid artery diseases were defined by the presence of any coronary artery calcification (CAC score>0) or carotid plaque, respectively.
Among the 6814 participants, 1932 had no traditional risk factors. A low- and high ABI were found in 176 (9%) and 149 (7.8%) cases, respectively. Lower glomerular filtration rate (OR: 0.88/10 units, p=0.04) and higher Interleukin-6 levels (OR: 1.42/natural-log unit, p=0.02) were associated with low ABI. Past smoking (cessation>10 years) and pulse pressure had borderline association with low ABI. In adjusted models, low-ABI was significantly associated with CAC prevalence (OR: 1.22, p<0.03). No significant association was found with carotid plaque.
In the absence of traditional CVD risk factors, LE-PAD is still common and associated with coronary artery disease.
下肢外周动脉疾病（LE-PAD）与传统危险因素（吸烟、高血压、血脂异常、糖尿病）密切相关。我们假设，在没有传统心血管疾病危险因素的情况下，LE-PAD 的患病率并非微不足道，而且这种情况仍与其他部位的亚临床动脉粥样硬化有关。
在动脉粥样硬化多民族研究中，我们根据踝臂指数（ABI）将没有任何传统危险因素的参与者分为 3 组：低（<1.00）、正常（1.00-1.30）和高（>1.30）ABI。冠状动脉或颈动脉疾病的定义为存在任何冠状动脉钙化（CAC 评分>0）或颈动脉斑块。
在 6814 名参与者中，有 1932 名没有传统危险因素。低 ABI 和高 ABI 分别在 176 例（9%）和 149 例（7.8%）患者中发现。较低的肾小球滤过率（OR：0.88/10 单位，p=0.04）和较高的白细胞介素-6 水平（OR：1.42/自然对数单位，p=0.02）与低 ABI 相关。过去吸烟（戒烟>10 年）和脉压与低 ABI 有边缘关联。在调整后的模型中，低 ABI 与 CAC 患病率显著相关（OR：1.22，p<0.03）。与颈动脉斑块无显著相关性。
在没有传统心血管疾病危险因素的情况下，LE-PAD 仍然很常见，并与冠状动脉疾病相关。
