Chudek J, Kocełak P, Ziaja D, Owczarek A, Ziaja K
Department of Pathophysiology Medical University of Silesia Katowice, 40-752 Katowice, Poland.
Int Angiol. 2013 Oct;32(5):471-8.
Obesity is of importance among the risk factors predisposing for chronic venous disorders (CVD). Little is known how obesity affects the management of CVD. As the data concerning the treatments of CVD in the obese are incomplete, we performed an analysis of the different CVD therapies managements with respect to body mass index and the obesity.
We analyzed 9797 CVD patients from of a previous large national CVD survey, in regard to their Body Mass Index (BMI), CVD class and CVD therapies. Among them 2213 patients presented class I, 516 class II or morbid obesity.
BMI was significantly associated with the method of CVD therapy. Logistic regression showed that venoactive drugs are preferentially used except in class I obesity patients but also when therapy is managed by general practitioner. Logistic regression analysis showed that class II and morbid obesity is associated with more frequent prevalence of previous surgical procedures related to CVD (OR=2.62 with 95% confidence interval of [2.16-3.17]) and topical agent use, (OR=1.77, [1.38-2.25]) but with a significant decreased compliance with compression therapy (OR=0.74, [0.61 - 0.89]), regardless of the clinical course of the disease, and socio-demographic factors. While class I obesity increased the adherence with VADs.
The therapy of CVD is affected by body mass index. Class II and morbid obese CVD patients are less frequently compliant with compression therapy but are willing to accept surgical procedures and the use of topical agents.
肥胖是慢性静脉疾病(CVD)的重要危险因素之一。目前对于肥胖如何影响CVD的治疗知之甚少。由于关于肥胖人群CVD治疗的数据不完整,我们针对体重指数和肥胖情况对不同的CVD治疗管理方法进行了分析。
我们分析了之前一项全国性大型CVD调查中的9797例CVD患者,涉及他们的体重指数(BMI)、CVD分级和CVD治疗方法。其中2213例患者为I级肥胖,516例为II级或病态肥胖。
BMI与CVD治疗方法显著相关。逻辑回归分析显示,除I级肥胖患者外,在由全科医生管理治疗时也更倾向使用活性药物。逻辑回归分析表明,II级和病态肥胖与既往CVD相关手术的更频繁发生率(OR = 2.62,95%置信区间为[2.16 - 3.17])以及局部用药(OR = 1.77,[1.38 - 2.25])相关,但无论疾病的临床进程和社会人口统计学因素如何,其压力治疗依从性显著降低(OR = 0.74,[0.61 - 0.89])。而I级肥胖增加了对静脉活性药物(VADs)的依从性。
CVD的治疗受体重指数影响。II级和病态肥胖的CVD患者压力治疗依从性较低,但愿意接受手术和局部用药。