Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Atherosclerosis. 2018 May;272:200-206. doi: 10.1016/j.atherosclerosis.2018.03.037. Epub 2018 Mar 22.
Peripheral artery disease (PAD) is associated with poor mobility and fatigue, but the relationship between preclinical ankle-brachial index (ABI) and early markers of fatigue and functional decline has not been defined.
570 adults, 50 and older, from the Baltimore Longitudinal Study of Aging (N = 570), with normal values of ABI (1-1.39), were classified into ABI tertiles. Perceived fatigability was assessed after a 5-min, treadmill walk (1.5 mph) using the Borg rating of perceived exertion (RPE, range 6-20). Functional evaluation included the Health, Aging and Body Composition Physical Performance Battery (HABC PPB), time to complete a 400-m corridor walk (LDCW), and VO peak (ml/kg/min). High RPE and poor walking endurance (PWE) were defined as RPE≥10 and taking >5 min for the LDCW, respectively. Differences between tertiles in fatigability and functional measures were tested adjusting for demographics, behavioral characteristics, self-reported fatigue, and medical history.
Mean LDCW time and RPE were greater for participants in the lowest tertile compared to those in the highest; mean VO peak and HABC PPB scores were lower, suggesting hierarchical associations between fatigability, functional performance, and ABI (p < 0.05 for all). Odds of PWE were greater for those in the lowest ABI tertile compared to the highest; odds of reporting high RPE were greater for those in the middle tertile.
Lower ABI is associated with poorer physical function and increased fatigability, suggesting that early changes in ABI may infer greater risk of functional decline, even among those who may not progress to PAD.
外周动脉疾病（PAD）与活动能力差和疲劳有关，但尚未明确亚临床踝臂指数（ABI）与疲劳和功能下降的早期标志物之间的关系。
570 名年龄在 50 岁及以上的成年人，来自巴尔的摩老龄化纵向研究（N=570），ABI 值正常（1-1.39），根据 ABI 分为三分位组。在 1.5 英里/小时的跑步机上行走 5 分钟后，使用 Borg 感知用力评分（RPE，范围 6-20）评估感知疲劳度。功能评估包括健康、衰老和身体成分体力表现电池（HABC PPB）、完成 400 米走廊行走（LDCW）的时间和 VO 峰值（ml/kg/min）。高 RPE 和较差的行走耐力（PWE）定义为 RPE≥10 和 LDCW 耗时>5 分钟。在调整人口统计学、行为特征、自我报告疲劳和病史后，测试了三分位组之间在疲劳和功能测量方面的差异。
与最高三分位组相比，最低三分位组的参与者 LDCW 时间和 RPE 更大；平均 VO 峰值和 HABC PPB 评分较低，表明疲劳、功能表现和 ABI 之间存在层次关联（所有 p<0.05）。与最高 ABI 三分位组相比，最低 ABI 三分位组发生 PWE 的可能性更大；中间三分位组报告高 RPE 的可能性更大。
较低的 ABI 与较差的身体功能和疲劳增加有关，这表明 ABI 的早期变化可能预示着功能下降的风险更大，即使在那些可能不会进展为 PAD 的人群中也是如此。
