Rose H G, Schweitzer P, Charoenkul V, Schwartz E
Arch Phys Med Rehabil. 1987 Jan;68(1):20-3.
Traumatic leg amputation, but not arm amputation, in World War II combat veterans has been associated with subsequent increased ischemic heart disease mortality. In a pilot project we examined a group of 19 high-risk Vietnam War veterans with bilateral above-knee amputations in comparison with a control group with unilateral below-elbow amputations. Nine of the 19 above-knee amputees were hypertensive (p = 0.05) and obese by hydrostatic weighing (p less than 0.001). Obesity was strongly associated with hypertension, decreased glucose tolerance, and marked hyperinsulinemia. Cigarette smoking, blood lipid abnormalities, and decreased cardiovascular fitness were not implicated as significant risk factors. Long-term risks of amputation may be related to metabolic and hemodynamic sequelae of excessive maturity-onset weight gain in young men immobilized by loss of lower limbs.
二战参战老兵中，腿部创伤性截肢而非手臂截肢与后续缺血性心脏病死亡率增加有关。在一个试点项目中，我们研究了一组19名患有双侧膝上截肢的高危越战老兵，并与一组单侧肘下截肢的对照组进行比较。19名膝上截肢者中有9人患有高血压（p = 0.05），通过静水称重法显示肥胖（p < 0.001）。肥胖与高血压、糖耐量降低和明显的高胰岛素血症密切相关。吸烟、血脂异常和心血管健康状况下降未被视为显著风险因素。截肢的长期风险可能与因下肢缺失而固定的年轻男性成年后体重过度增加所导致的代谢和血液动力学后遗症有关。
