Novel risk factors for peripheral arterial disease in young women.

Abstract

PURPOSE:

To investigate traditional and novel risk factors (homocysteine and C-reactive protein levels, and exposure to infections) for peripheral arterial disease in young women.

SUBJECTS AND METHODS:

In a multicenter, population-based, case-control study, 212 young women (mean [+/- SD] age, 48.2 +/- 7.0 years) with peripheral arterial disease and 475 healthy control women (mean age, 45.5 +/- 8.1 years) completed a standardized questionnaire and provided blood samples. Peripheral arterial disease was angiographically confirmed if a stenotic lesion (more than 50% reduction of the lumen) was present in at least one major peripheral artery. Hyperhomocysteinemia was defined as a nonfasting plasma homocysteine level exceeding the 90th percentile of the control group. History of infectious diseases was determined by questionnaire.

RESULTS:

Elevated C-reactive protein levels were associated with an increased likelihood of peripheral arterial disease (odds ratio [OR] = 3.9; 95% confidence interval [CI]: 1.8 to 8.5 for women in the third quartile; OR = 3.1; 95% CI: 1.4 to 6.8 for women in the fourth quartile; both comparisons with women in the first quartile). Hyperhomocysteinemia was not associated with a significantly increased risk of peripheral arterial disease (OR = 1.6; 95% CI: 0.9 to 3.0). A history of chickenpox, shingles, mumps, pneumonia, chronic bronchitis, peptic ulcer, or periodontitis was independently related to peripheral arterial disease, with adjusted odds ratios varying from 1.7 (95% CI: 1.0 to 3.1) for mumps to 3.4 (95% CI: 1.5 to 7.7) for peptic ulcer. The risk of peripheral arterial disease increased with the number of these infections; exposure to five or more infections increased the odds 3.7-fold (95% CI: 1.7 to 8.2). This association was not affected by the level of C-reactive protein.

CONCLUSION:

Our results do not support a strong relation between homocysteine and peripheral arterial disease in young women. However, an elevated C-reactive protein level and several types of symptomatic infection were associated with peripheral arterial disease.

• Authors: Daisy G M Bloemenkamp, Maurice A A J van den Bosch, Willem P Th M Mali, Bea C Tanis, Frits R Rosendaal, Jeanet M Kemmeren, Ale Algra, Frank L J Visseren, Yolanda van der Graaf
• Journal: The American journal of medicine (Am J Med) Vol. 113 Issue 6 Pg. 462-7 (Oct 15 2002) ISSN: 0002-9343 [Print] United States
• PMID: 12427494 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Homocysteine
• C-Reactive Protein

Topics

• Arteriosclerosis (blood, etiology)
• C-Reactive Protein (analysis)
• Case-Control Studies
• Female
• Homocysteine (blood)
• Humans
• Infections (complications)
• Leg (blood supply)
• Middle Aged
• Odds Ratio
• Peripheral Vascular Diseases (blood, etiology)
• Risk Factors