Wang Grace J, Shaw Pamela A, Townsend Raymond R, Anderson Amanda H, Xie Dawei, Wang Xue, Nessel Lisa C, Mohler Emile R, Sozio Stephen M, Jaar Bernard G, Chen Jing, Wright Jackson, Taliercio Jonathan J, Ojo Akinlolu, Ricardo Ana C, Lustigova Eva, Fairman Ronald M, Feldman Harold I, Ky Bonnie
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA.
Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Ann Vasc Surg. 2016 Aug;35:111-20. doi: 10.1016/j.avsg.2016.02.010. Epub 2016 May 20.
Peripheral artery disease (PAD) is highly prevalent and associated with significant morbidity and mortality, but sex-based differences are incompletely understood. We sought to define the associations between PAD and physical outcome measures and to determine if these associations differed by sex in the Chronic Renal Insufficiency Cohort.
Among 3,543 participants, we assessed the cross-sectional relationship between PAD severity defined by ankle-brachial index; and (1) physical activity (metabolic equivalent [MET]-hr/wk), (2) walking pace (slow versus medium and/or fast), and (3) physical function (12-item Short Form Health Survey [SF-12]) at baseline.
In a multivariable linear regression model, PAD severity was not associated with physical activity defined by total MET-hr per wk in men or women (P = 0.432). However, PAD severity was significantly associated with walking activity (P = 0.037), although this relationship did not differ by sex (P = 0.130). Similarly, PAD severity was significantly associated with walking pace (P < 0.001), although this relationship did not differ by sex (P = 0.086). In contrast, there was an independent association between PAD severity and SF-12 (P = 0.018), with a significant interaction by sex (P < 0.001).
These data suggest that tools used to evaluate the functional consequences of PAD should focus on walking activity and walking pace, as well as physical function, where sex-specific associations should be accounted for.
外周动脉疾病（PAD）非常普遍，且与显著的发病率和死亡率相关，但基于性别的差异尚未完全明确。我们试图确定PAD与身体结局指标之间的关联，并确定在慢性肾功能不全队列中这些关联是否因性别而异。
在3543名参与者中，我们评估了由踝臂指数定义的PAD严重程度与以下指标在基线时的横断面关系：（1）身体活动量（代谢当量[MET]-小时/周）、（2）步行速度（慢与中速和/或快速），以及（3）身体功能（12项简短健康调查问卷[SF-12]）。
在多变量线性回归模型中，PAD严重程度与男性或女性每周总MET-小时定义的身体活动量无关（P = 0.432）。然而，PAD严重程度与步行活动显著相关（P = 0.037），尽管这种关系在性别上没有差异（P = 0.130）。同样，PAD严重程度与步行速度显著相关（P < 0.001），尽管这种关系在性别上没有差异（P = 0.086）。相比之下，PAD严重程度与SF-12之间存在独立关联（P = 0.018），且存在显著的性别交互作用（P < 0.001）。
这些数据表明，用于评估PAD功能后果的工具应关注步行活动、步行速度以及身体功能，其中应考虑性别特异性关联。
