Portal de investigação
Inflammation and Loss of Skeletal Muscle Mass in Chronic Limb Threatening Ischemia
Autores da FMUP
Participantes de fora da FMUP
- Ferreira, Joana
- Carneiro, Alexandre
- Vila, Isabel
- Silva, Cristina
- Cunha, Cristina
- Longatto-Filho, Adhemar
- Mesquita, Amilcar
- Cotter, Jorge
- Correia-Neves, Margarida
- Cunha, Pedro
Unidades de investigação
Abstract
Background: Lower extremity peripheral arterial disease (PAD) is an atherosclerotic disease of the lower extremities. Atherosclerosis, inflammation, and sarcopenia are independently associated and potentiate each other. Inflammation is deeply involved in the formation and progression of atherosclerosis and is also involved in the pathophysiology of sarcopenia. Sarcopenia is defined as low muscle mass, with low muscle strength. This study aims to determine the differences in skeletal muscle characteristics and in inflammatory parameters between patients with claudication and with chronic limb threatening ischemia (CLTI). Methods: An observational, prospective study in patients with PAD was conducted from January 2018 to December 2020. The clinical characteristics and the cardiovascular risk factors were prospectively registered. The inflammatory parameters determined were: positive acute phase proteins (C-reactive Protein- CRP- and fibrinogen) and negative acute phase proteins albumin, total cholesterol and high-density lipoprotein (HDL). The skeletal muscle area and density were quantified with a computed topography (CT) scan. The strength was determined with a Results: A total of 116 patients (mean age: 67.65 +/- 9.53 years-old) 64% with claudication and 46% with CLTI were enrolled in the study. No differences were registered between patients with claudication and CLTI on age, cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, and smoking habits) and medication. There was a higher prevalence of men in the clau- dication group (88.89% vs. 71.70%, P = 0.019). Analyzing the inflammatory parameters, we noted that patients with CLTI had increased serum levels of positive acute phase proteins: CRP (37.53 +/- 46.61 mg/L vs. 9.18 +/- 26.12 mg/L, P = 0.000), and fibrinogen (466.18 +/- 208.07 mg/dL vs. 317.37 +/- 79.42 mg/dL, P = 0.000). CLTI patients had decreased negative acute phase proteins: albumin (3.53 +/- 0.85 g/dL vs. 3.91 +/- 0.72 g/dL, P = 0.001), total cholesterol (145.41 +/- 38.59 mg/dL vs. 161.84 +/- 34.94 mg/dL, P = 0.013) and HDL (38.70 +/- 12.19 mg/dL vs. 51.31 +/- 15.85 mg/dL, P = 0.000). We noted that patients with CLTI had lower skeletal muscle area and mass (14,349.77 +/- 3,036.60 mm2 vs. 15,690.56 +/- 3,183.97 mm2 P = 0.013; 10.11 +/- 17.03HU vs. 18.02 +/- 13.63HU P = 0.013). After adjusting for the variable sex, the association between skeletal muscle density and CLTI per- sisted (r (97) =-0.232, P = 0.021). The groups did not differ in strength (patients with claudica- tion: 25.39 +/- 8.23 Kgf vs. CLTI: 25.17 +/- 11.95 Kgf P = 0.910). Conclusions: CLTI patients have decreased skeletal muscle mass and a systemic inflamma- tion status. Recognizing the deleterious triad of atherosclerosis, inflammation and loss of skel- etal mass patients with CLTI is an opportunity to improve medical therapy and to perform a timely intervention to stop this vicious cycle.
Copyright © 2022 Elsevier Inc. All rights reserved.
Dados da publicação
- ISSN/ISSNe:
- 1615-5947, 0890-5096
- Tipo:
- Article
- Páginas:
- 164-173
- Link para outro recurso:
- www.scopus.com
Annals of Vascular Surgery Elsevier Inc.
Citações Recebidas na Web of Science: 12
Citações Recebidas na Scopus: 11
Documentos
- Não há documentos
Filiações
Keywords
- ATHEROSCLEROSIS SYNDROME; CARDIOVASCULAR-DISEASE; RISK-FACTORS; MALNUTRITION; SARCOPENIA; ASSOCIATION; COAGULATION; ACTIVATION; MARKERS
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Citar a publicação
Ferreira J,Carneiro A,Vila I,Silva C,Cunha C,Longatto A,Mesquita A,Cotter J,Mansilha A,Correia M,Cunha P. Inflammation and Loss of Skeletal Muscle Mass in Chronic Limb Threatening Ischemia. Ann. Vasc. Surg. 2023. 88. p. 164-173. IF:1,500. (3).
