Department of Cardiology, Ina Central Hospital, Ina, Japan.
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
Heart Vessels. 2021 Dec;36(12):1830-1840. doi: 10.1007/s00380-021-01883-2. Epub 2021 Jun 7.
An inverse correlation between body mass index and mortality in patients with peripheral artery disease (PAD) has been reported. However, little information is available regarding the impact of body composition on the clinical outcomes in patients with PAD. This study evaluated the relationships between the lean body mass index (LBMI), body fat % (BF%), and mortality and major amputation rate in patients with PAD. We evaluated 320 patients with PAD after endovascular treatment (EVT) enrolled from August 2015 to July 2016 and divided them into low and high LBMI and BF% groups based on their median values (17.47 kg/m and 22.07%, respectively). We assessed 3-year mortality and major amputation for the following patient groups: Low LBMI/Low BF%, Low LBMI/High BF%, High LBMI/Low BF%, and High LBMI/High BF%. During the median 3.1-year follow-up period, 70 (21.9%) patients died and 9 (2.9%) patients experienced major amputation. The survival rate was lower in the Low LBMI than in the High LBMI group, and was not significantly different between the Low and High BF% groups. Survival rates were lowest in the Low LBMI/Low BF% group (57.5%) and highest in the High LBMI/High BF% group (94.4%). There were no significant differences in major amputation rate between the Low LBMI and High LBMI groups, and between the Low BF% and High BF% groups. The Low LBMI and Low BF% groups were associated with an increased risk of mortality after adjustment for age, sex, frailty and conventional risk factors [hazard ratio (HR): 4.02; 95% confidence interval (CI) 2.10-7.70; p < 0.001 and HR: 4.48; 95% CI 1.58-12.68, p = 0.005, respectively], for age, sex, hemodialysis, and prior cerebral cardiovascular disease (HR: 3.63; 95% CI 1.93-6.82; p < 0.001 and HR: 4.03; 95% CI 1.43-11.42, p = 0.009, respectively) and for age, sex, and laboratory date (HR: 3.97; 95% CI 1.88-8.37; p < 0.001 and HR: 3.31; 95% CI 1.15-9.53, p = 0.026, respectively). In conclusion, Low LBMI and Low BF% were associated with poor prognosis in patients undergoing EVT for PAD, and mortality was the lowest in the High LBMI/High BF% group compared with other body composition groups.
已有研究报道，外周动脉疾病（PAD）患者的体重指数（BMI）与死亡率呈负相关。然而，关于身体成分对 PAD 患者临床结局的影响的信息却很少。本研究评估了瘦体重指数（LBMI）、体脂肪%（BF%）与 PAD 患者死亡率和主要截肢率之间的关系。我们评估了 2015 年 8 月至 2016 年 7 月间接受血管内治疗（EVT）的 320 名 PAD 患者，并根据中位数（分别为 17.47kg/m 和 22.07%）将他们分为低 LBMI 和高 BF%组和低 LBMI 和高 BF%组。我们评估了以下患者组的 3 年死亡率和主要截肢率：低 LBMI/低 BF%、低 LBMI/高 BF%、高 LBMI/低 BF%和高 LBMI/高 BF%。在中位 3.1 年随访期间，70 名（21.9%）患者死亡，9 名（2.9%）患者发生主要截肢。与高 LBMI 组相比，LBMI 较低的患者生存率较低，且低 LBMI 组与高 BF%组之间的生存率无显著差异。低 LBMI/低 BF%组的生存率最低（57.5%），高 LBMI/高 BF%组的生存率最高（94.4%）。LBMI 较低的患者与高 LBMI 患者的主要截肢率无显著差异，低 BF%组与高 BF%组之间也无显著差异。LBMI 较低和 BF%较低与年龄、性别、虚弱和常规危险因素调整后的死亡率增加相关[风险比（HR）：4.02；95%置信区间（CI）：2.10-7.70；p<0.001 和 HR：4.48；95%CI 1.58-12.68，p=0.005]，与年龄、性别、血液透析和既往心脑血管疾病相关[HR：3.63；95%CI 1.93-6.82；p<0.001 和 HR：3.63；95%CI 1.93-6.82；p<0.001]，与年龄、性别和实验室数据相关[HR：3.97；95%CI 1.88-8.37；p<0.001 和 HR：3.31；95%CI 1.15-9.53，p=0.026]。总之，LBMI 较低和 BF%较低与 EVT 治疗 PAD 患者的预后不良相关，与其他身体成分组相比，高 LBMI/高 BF%组的死亡率最低。
