Association of diabetic peripheral arterial disease and objectively-measured physical activity: NHANES 2003-2004

Journal of Diabetes & Metabolic Disorders

Kalen Abbott¹  Paul D Loprinzi² 

[1] Maricopa Integrated Health System, Phoenix, AZ, USA;Departments of Exercise Science and Physical Therapy, Donna & Allan Lansing School of Nursing & Health Sciences, Bellarmine University, Louisville, KY 40205, USA

关键词: National Health and Nutrition Examination Survey (NHANES);    Exercise;    Epidemiology;    Accelerometry;   

Others  :  803406
DOI  :  10.1186/2251-6581-13-63

 received in 2014-03-29, accepted in 2014-05-17,  发布年份 2014

【 摘 要 】

Background

Although much is known about the management of peripheral arterial disease among adults in the general population, the management of this disease among those with diabetes, and the effects of diabetic-induced peripheral arterial disease on objectively-measured physical activity, is unclear. Here, we examined the association between accelerometer-assessed physical activity and peripheral arterial disease among a national sample of U.S. adults with diabetes.

Methods

Data from the 2003–2004 National Health and Nutrition Examination Survey were used. Physical activity was measured using an accelerometer in 254 adults with diabetes. Peripheral arterial disease was assessed via ankle brachial index. Negative binomial regression analysis was used to examine the association between physical activity and peripheral arterial disease.

Results

Results were adjusted for age, gender, race-ethnicity, comorbidity index, smoking, HgbA1C, C-reactive protein, homocysteine, glomerular filtration rate, microalbuminuria, peripheral neuropathy, physical functioning, and medication use. After adjustments, participants with peripheral arterial disease engaged in 23% less physical activity (RR = 0.77, 95% CI: 0.62-0.96) than those without peripheral arterial disease.

Conclusions

These findings demonstrate an inverse association between accelerometer-assessed physical activity and peripheral arterial disease in a national sample of U.S adults with diabetes.

【 授权许可】

   
2014 Loprinzi and Abbott; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]American Diabetes Association: Peripheral arterial disease in people with diabetes. Diabetes Care 2003, 26:3333-3341.
• [2]Fowkes FG, Murray GD, Butcher I, Heald CL, Lee RJ, Chambless LE, Folsom AR, Hirsch AT, Dramaix M, De Backer G, Wautrecht JC, Kornitzer M, Newman AB, Cushman M, Sutton-Tyrrell K, Lee AJ, Price JF, d’Agostino RB, Murabito JM, Norman PE, Jamrozik K, Curb JD, Masaki KH, Rodriguez BL, Dekker JM, Bouter LM, Heine RJ, Nijpels G, Stehouwer CD, Ferrucci L, et al.: Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA 2008, 300:197-208.
• [3]Gregg EW, Sorlie P, Paulose-Ram R, Gu Q, Eberhardt MS, Wolz M, Burt V, Curtin L, Engelgau M, Geiss L: Prevalence of lower-extremity disease in the US adult population > =40 years of age with and without diabetes: 1999–2000 national health and nutrition examination survey. Diabetes Care 2004, 27:1591-1597.
• [4]Criqui MH: Peripheral arterial disease–epidemiological aspects. Vasc Med 2001, 6:3-7.
• [5]Loprinzi P, Cardinal B, Crespo C, Brodowicz G, Andersen R, Sullivan E, Smit E: Objectively measured physical activity and C-reactive protein: National Health and Nutrition Examination Survey 2003–2004. Scand J Med Sci Sports 2013, 23:164-170.
• [6]Loprinzi PD, Ramulu PY: Objectively measured physical activity and inflammatory markers among US adults with diabetes: implications for attenuating disease progression. Mayo Clin Proc 2013, 88:942-951.
• [7]McDermott MM, Greenland P, Liu K, Guralnik JM, Celic L, Criqui MH, Chan C, Martin GJ, Schneider J, Pearce WH, Taylor LM, Clark E: The ankle brachial index is associated with leg function and physical activity: the Walking and Leg Circulation Study. Ann Intern Med 2002, 136:873-883.
• [8]Gardner AW, Sieminski DJ, Montgomery PS: Physical activity is related to ankle/brachial index in subjects without peripheral arterial occlusive disease. Angiology 1997, 48:883-891.
• [9]McDermott MM, Guralnik JM, Tian L, Liu K, Ferrucci L, Liao Y, Sharma L, Criqui MH: Associations of borderline and low normal ankle-brachial index values with functional decline at 5-year follow-up: the WALCS (Walking and Leg Circulation Study). J Am Coll Cardiol 2009, 53:1056-1062.
• [10]Fitzpatrick SE, Reddy S, Lommel TS, Fischer JG, Speer EM, Stephens H, Park S, Johnson MA: Physical activity and physical function improved following a community-based intervention in older adults in Georgia senior centers. J Nutr Elder 2008, 27:135-154.
• [11]Gardner AW, Katzel LI, Sorkin JD, Killewich LA, Ryan A, Flinn WR, Goldberg AP: Improved functional outcomes following exercise rehabilitation in patients with intermittent claudication. J Gerontol A Biol Sci Med Sci 2000, 55:M570-M577.
• [12]Loprinzi PD, Cardinal B: Measuring children’s physical activity and sedentary behaviors. J Exercise Sci Fitness 2011, 9:15-23.
• [13]Van Poppel MN, Chinapaw MJ, Mokkink LB, Van Mechelen W, Terwee CB: Physical activity questionnaires for adults: a systematic review of measurement properties. Sports Med 2010, 40:565-600.
• [14]Ix JH, Biggs ML, Kizer JR, Mukamal KJ, Djousse L, Zieman SJ, De Boer IH, Nelson TL, Newman AB, Criqui MH, Siscovick DS: Association of body mass index with peripheral arterial disease in older adults: the Cardiovascular Health Study. Am J Epidemiol 2011, 174:1036-1043.
• [15]Planas A, Clara A, Pou JM, Vidal-Barraquer F, Gasol A, De Moner A, Contreras C, Marrugat J: Relationship of obesity distribution and peripheral arterial occlusive disease in elderly men. Int J Obes Relat Metab Disord 2001, 25:1068-1070.
• [16]Alzahrani HA, Wang D, Bakhotmah BA, Hu FB: Risk factors for peripheral artery disease among patients with diabetes in Saudi Arabia. Vasc Med 2014, 19:103-111.
• [17]Prince SA, Adamo KB, Hamel ME, Hardt J, Connor Gorber S, Tremblay M: A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act 2008, 5:56.
• [18]Centers for Disease Control and Prevention: National health and nutrition examination survey. Available at: http://www.cdc.gov/nchs/nhanes/about_nhanes.htm webcite
• [19]Potier L, Abi Khalil C, Mohammedi K, Roussel R: Use and utility of ankle brachial inded in patients with diabetes. Eur J Vasc Endovasc Surg 2011, 41:110-116.
• [20]Bernstein EF, Fronek A: Current status of noninvasive tests in the diagnosis of peripheral arterial disease. Surg Clin North Am 1982, 62:473-487.
• [21]Resnick HE, Lindsay RS, McDermott MM, Devereux RB, Jones KL, Fabsitz RR, Howard BV: Relationship of high and low ankle brachial index to all-cause and cardiovascular disease mortality: the Strong Heart Study. Circulation 2004, 109:733-739.
• [22]Wu CK, Yang CY, Tsai CT, Chiu FC, Huang YT, Lee JK, Cheng CL, Lin LY, Lin JW, Hwang JJ, Chiang FT: Association of low glomerular filtration rate and albuminuria with peripheral arterial disease: the National Health and Nutrition Examination Survey, 1999–2004. Atherosclerosis 2010, 209:230-234.
• [23]Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M: Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008, 40:181-188.
• [24]Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, Januel JM, Sundararajan V: Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 2011, 173:676-682.
• [25]Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J: A new equation to estimate glomerular filtration rate. Ann Intern Med 2009, 150:604-612.
• [26]Erman A, Rahamimov R, Mashraki T, Levy-Drummer RS, Winkler J, David I, Hirsh Y, Gafter U, Chagnac A: The urine albumin-to-creatinine ratio: assessment of its performance in the renal transplant recipient population. Clin J Am Soc Nephrol 2011, 6:892-897.
• [27]Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J, Hann AW, Hussein A, Jackson N, Johnson KE, Ryder CH, Torkington R, Van Ross ER, Whalley AM, Widdows P, Williamson S, Boulton AJ: The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. Diabet Med 2002, 19:377-384.
• [28]Kalyani RR, Saudek CD, Brancati FL, Selvin E: Association of diabetes, comorbidities, and A1C with functional disability in older adults: results from the National Health and Nutrition Examination Survey (NHANES), 1999–2006. Diabetes Care 2010, 33:1055-1060.
• [29]Loprinzi PD, Smit E, Lin FR, Gilham B, Ramulu PY: Accelerometer-assessed physical activity and objectively determined dual sensory impairment in US adults. Mayo Clin Proc 2013, 88:690-696.
• [30]Loprinzi PD, Cardinal BJ: Interrelationships among physical activity, depression, homocysteine, and metabolic syndrome with special considerations by sex. Prev Med 2012, 54:388-392.
• [31]Nascimento CM, Stella F, Garlipp CR, Santos RF, Gobbi S, Gobbi LT: Serum homocysteine and physical exercise in patients with Parkinson’s disease. Psychogeriatrics 2011, 11:105-112.
• [32]Petidis K, Douma S, Doumas M, Basagiannis I, Vogiatzis K, Zamboulis C: The interaction of vasoactive substances during exercise modulates platelet aggregation in hypertension and coronary artery disease. BMC Cardiovasc Disord 2008, 8:11.
• [33]Ernst E: Influence of regular physical activity on blood rheology. Eur Heart J 1987, 8(Suppl G):59-62.
• [34]Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH: Plasma concentration of C-reactive protein and risk of developing peripheral vascular disease. Circulation 1998, 97:425-428.
• [35]Mahajan A, Tabassum R, Chavali S, Dwivedi OP, Bharadwaj M, Tandon N, Bharadwaj D: High-sensitivity C-reactive protein levels and type 2 diabetes in urban North Indians. J Clin Endocrinol Metab 2009, 94:2123-2127.
• [36]Albert MA, Glynn RJ, Ridker PM: Effect of physical activity on serum C-reactive protein. Am J Cardiol 2004, 93:221-225.
• [37]Brenner I, Parry M, Brown CA: Exercise interventions for patients with peripheral arterial disease: a review of the literature. Phys Sportsmed 2012, 40:41-55.
• [38]Crowther RG, Leicht AS, Spinks WL, Sangla K, Quigley F, Golledge J: Effects of a 6-month exercise program pilot study on walking economy, peak physiological characteristics, and walking performance in patients with peripheral arterial disease. Vasc Health Risk Manag 2012, 8:225-232.