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Gesundheitswesen 2005; 67: 57-61
DOI: 10.1055/s-2005-858244
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Ankle-Brachial Index and Peripheral Arterial Disease

Knöchel-Arm-Index und periphere arterielle VerschlusskrankheitC. Lamina1 , C. Meisinger1 , I. M. Heid1 , B. Rantner2 , A. Döring1 , H. Löwel1 , H. E. Wichmann1 , F. Kronenberg1, 2
  • 1GSF National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
  • 2Innsbruck Medical University, Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology, Innsbruck, Austria
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Publication History

Publication Date:
19 July 2005 (online)

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Zusammenfassung

Patienten mit peripherer Arteriosklerose und insbesondere solche mit Claudicatio intermittens haben ein deutlich erhöhtes Risiko für kardio- und zerebrovaskuläre Morbidität und Mortalität. Das Schicksal dieser Patienten wird weniger durch lokale Komplikationen im Bein als durch systemische Komplikationen im Bereich der koronaren und der zerebralen Gefäße geprägt. Durch Untersuchungen in der KORA-Studie 2004/2005 (F3), einer Nachuntersuchung der Teilnehmer der MONICA-Studie 1994/1995 (S3), werden wir versuchen, biochemische sowie genetische Risikofaktoren für die periphere arterielle Verschlusskrankheit zu identifizieren. Einer der uns besonders interessierenden Kandidaten ist das antiatherogene Apolipoprotein A-IV.

Abstract

Patients with peripheral arterial disease including those with intermittent claudication have a high risk for cardiovascular and cerebrovascular morbidity and mortality. The outcome of patients with intermittent claudication is less limited by local complications in the leg than by the systemic complications of coronary and cerebral vessels. About 30 % of these patients will die within 5 years, three-quarters of them due to vascular events. Analyses using data of the KORA Study 2004/2005 (F3), a follow-up examination of the participants of the MONICA Survey 1994/95 (S3), will try to identify biochemical as well as genetic risk factors for peripheral arterial disease. The anti-atherogenic apolipoprotein A-IV will be one of our candidates of interest.

Schlüsselwörter

Periphere Atherosklerose - Claudicatio intermittens - KORA - Genetik - Apolipoprotein A-IV

Key words

Peripheral arterial disease - intermittent claudication - KORA - genetics - apolipoprotein A-IV

References

  • 1 Management of peripheral arterial disease (PAD) . TransAtlantic Inter-Society Consensus (TASC).  Int Angiol. 2000;  19 (Suppl 1) 1-304
    PubMedGoogle Scholar
  • 2 Kazamias T M, Gander M P, Franklin D L. et al . Blood pressure measurement with Doppler ultrasonic flowmeter.  J Appl Physiol. 1971;  30 585-588
    PubMedGoogle Scholar
  • 3 Stegall H F, Kardon M B, Kemmerer W T. Indirect measurment of arterial blood pressure by Doppler ultrasonic sphygmomanometry.  J Appl Physiol. 1968;  25 793-798
    PubMedGoogle Scholar
  • 4 Fowkes F G, Housley E, Macintyre C C. et al . Variability of ankle and brachial systolic pressures in the measurement of atherosclerotic peripheral arterial disease.  J Epidemiol Community Health. 1988;  42 128-133
    PubMedGoogle Scholar
  • 5 Schroll M, Munck O. Estimation of peripheral arteriosclerotic disease by ankle blood pressure measurements in a population study of 60-year-old men and women.  J Chronic Dis. 1981;  34 261-269
    PubMedGoogle Scholar
  • 6 Laing S, Greenhalgh R M. The detection and progression of asymptomatic peripheral arterial disease.  Br J Surg. 1983;  70 628-630
    CrossrefPubMedGoogle Scholar
  • 7 Carter S A. Indirect systolic pressures and pulse waves in arterial occlusive diseases of the lower extremities.  Circulation. 1968;  37 624-637
    CrossrefPubMedGoogle Scholar
  • 8 Leng G C, Fowkes F G. The Edinburgh Claudication Questionnaire: an improved version of the WHO/Rose Questionnaire for use in epidemiological surveys.  J Clin Epidemiol. 1992;  45 1101-1109
    PubMedGoogle Scholar
  • 9 Hiatt W R, Hoag S, Hamman R F. Effect of diagnostic criteria on the prevalence of peripheral arterial disease. The San Luis Valley Diabetes Study.  Circulation. 1995;  91 1472-1479
    CrossrefPubMedGoogle Scholar
  • 10 Diehm C, Schuster A, Allenberg J R. et al . High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study.  Atherosclerosis. 2004;  172 95-105
    CrossrefPubMedGoogle Scholar
  • 11 Meijer W T, Hoes A W, Rutgers D. et al . Peripheral arterial disease in the elderly - The Rotterdam study.  Arterioscler Thromb Vasc Biol. 1998;  18 185-192
    CrossrefPubMedGoogle Scholar
  • 12 Murabito J M, D’Agostino R B, Silbershatz H. et al . Intermittent claudication. A risk profile from The Framingham Heart Study.  Circulation. 1997;  96 44-49
    CrossrefPubMedGoogle Scholar
  • 13 Hughson W G, Mann J I, Garrod A. Intermittent claudication: prevalence and risk factors.  BMJ. 1978;  1 1379-1381
    PubMedGoogle Scholar
  • 14 Hertzer N R, Beven E G, Young J R. et al . Coronary artery disease in peripheral vascular patients. A classification of 1000 coronary angiograms and results of surgical management.  Ann Surg. 1984;  199 223-233
    CrossrefPubMedGoogle Scholar
  • 15 Crawford E S, Bomberger R A, Glaeser D H. et al . Aortoiliac occlusive disease: factors influencing survival and function following reconstructive operation over a twenty-five-year period.  Surgery. 1981;  90 1055-1067
    PubMedGoogle Scholar
  • 16 Aronow W S, Ahn C. Prevalence of coexistence of coronary artery disease, peripheral arterial disease, and atherothrombotic brain infarction in men and women > or = 62 years of age.  Am J Cardiol. 1994;  74 64-65
    CrossrefPubMedGoogle Scholar
  • 17 Murabito J M, Evans J C, Nieto K. et al . Prevalence and clinical correlates of peripheral arterial disease in the Framingham Offspring Study.  Am Heart J. 2002;  143 961-965
    CrossrefPubMedGoogle Scholar
  • 18 Jönsson B, Skau T. Ankle-brachial index and mortality in a cohort of questionnaire recorded leg pain on walking.  Eur J Vasc Endovasc Surg. 2002;  24 405-410
    CrossrefPubMedGoogle Scholar
  • 19 Jager A, Kostense P J, Ruhe H G. et al . Microalbuminuria and peripheral arterial disease are independent predictors of cardiovascular and all-cause mortality, especially among hypertensive subjects: five-year follow-up of the Hoorn Study.  Arterioscler Thromb Vasc Biol. 1999;  19 617-624
    PubMedGoogle Scholar
  • 20 Muluk S C, Muluk V S, Kelley M E. et al . Outcome events in patients with claudication: a 15-year study in 2777 patients.  J Vasc Surg. 2001;  33 251-257
    PubMedGoogle Scholar
  • 21 Labs K H, Dormandy J A, Jaeger K A. et al . Trans-atlantic conference on clinical trial guidelines in PAOD (Peripheral arterial occlusive disease) clinical trial methodology.  Eur J Vasc Endovasc Surg. 1999;  18 253-265
    CrossrefPubMedGoogle Scholar
  • 22 Utermann G, Beisiegel U. Apolipoprotein A-IV: a protein occurring in human mesenteric lymph chylomicrons and free in plasma. solation and quantification.  Eur J Biochem. 1979;  99 333-343
    CrossrefPubMedGoogle Scholar
  • 23 Stein O, Stein Y, Lefevre M. et al . The role of apolipoprotein A-IV in reverse cholesterol transport studied with cultured cells and liposomes derived from another analog of phosphatidylcholine.  Biochim Biophys Acta. 1986;  878 7-13
    PubMedGoogle Scholar
  • 24 Steinmetz A, Barbaras R, Ghalim N. et al . Human apolipoprotein A-IV binds to apolipoprotein A-I/A-II receptor sites and promotes cholesterol efflux from adipose cells.  J Biol Chem. 1990;  265 7859-7863
    PubMedGoogle Scholar
  • 25 Steinmetz A, Utermann G. Activation of lecithin: cholesterol acyltransferase by human apolipoprotein A-IV.  J Biol Chem. 1985;  260 2258-2264
    PubMedGoogle Scholar
  • 26 Chen C H, Albers J J. Activation of lecithin: cholesterol acyltransferase by apolipoproteins E-2, E-3 and A-IV isolated from human plasma.  Biochim Biophys Acta. 1985;  836 279-285
    PubMedGoogle Scholar
  • 27 Goldberg I J, Scheraldi C A, Yacoub L K. et al . Lipoprotein ApoC-II activation of lipoprotein lipase. Modulation by apolipoprotein A-IV.  J Biol Chem. 1990;  265 4266-4272
    PubMedGoogle Scholar
  • 28 Guyard-Dangremont V, Lagrost L, Gambert P. Comparative effects of purified apolipoproteins A-I, A-II, and A- IV on cholesteryl ester transfer protein activity.  J Lipid Res. 1994;  35 982-992
    PubMedGoogle Scholar
  • 29 Qin X F, Swertfeger D K, Zheng S Q. et al . Apolipoprotein AIV: A potent endogenous inhibitor of lipid oxidation.  Am J Physiol. 1998;  274 H1836-H1840
    PubMedGoogle Scholar
  • 30 Ostos M A, Conconi M, Vergnes L. et al . Antioxidative and antiatherosclerotic effects of human apolipoprotein A-IV in apolipoprotein E-deficient mice.  Arterioscler Thromb Vasc Biol. 2001;  21 1023-1028
    PubMedGoogle Scholar
  • 31 Drazen D L, Woods S C. Peripheral signals in the control of satiety and hunger.  Curr Opin Clin Nutr Metab Care. 2003;  6 621-629
    PubMedGoogle Scholar
  • 32 Lefevre M, Lovejoy J C, DeFelice S M. et al . Common apolipoprotein A-IV variants are associated with differences in body mass index levels and percentage body fat.  Int J Obes Relat Metab Disord. 2000;  24 945-953
    CrossrefPubMedGoogle Scholar
  • 33 Fiegenbaum M, Hutz M H. Further evidence for the association between obesity-related traits and the apolipoprotein A-IV gene.  Int J Obes Relat Metab Disord. 2003;  27 484-490
    PubMedGoogle Scholar
  • 34 Lingenhel A, Eder C, Zwiauer K. et al . Decrease of plasma apolipoprotein A-IV during weight reduction in obese adolescents on a low fat diet.  Int J Obes. 2004;  28 1509-1513
    CrossrefPubMedGoogle Scholar
  • 35 Duverger N, Tremp G, Caillaud J M. et al . Protection against atherogenesis in mice mediated by human apolipoprotein A-IV.  Science. 1996;  273 966-968
    PubMedGoogle Scholar
  • 36 Cohen R D, Castellani L W, Qiao J H. et al . Reduced aortic lesions and elevated high density lipoprotein levels in transgenic mice overexpressing mouse apolipoprotein A-IV.  J Clin Invest. 1997;  99 1906-1916
    PubMedGoogle Scholar
  • 37 Kronenberg F, Stühlinger M, Trenkwalder E. et al . Low apolipoprotein A-IV plasma concentrations in men with coronary artery disease.  J Am Coll Cardiol. 2000;  36 751-757
    PubMedGoogle Scholar
  • 38 Duverger N, Ghalim N, Ailhaud G. et al . Characterization of apoA-IV-containing lipoprotein particles isolated from human plasma and interstitial fluid.  Arterioscler Thromb. 1993;  13 126-132
    PubMedGoogle Scholar
  • 39 Von Eckardstein A, Huang Y, Wu S. et al . Lipoproteins containing apolipoprotein A-IV but not apolipoprotein A-I take up and esterify cell-derived cholesterol in plasma.  Arterioscler Thromb Vasc Biol. 1995;  15 1755-1763
    PubMedGoogle Scholar
  • 40 Kronenberg F, Kuen E, Ritz E. et al . Apolipoprotein A-IV serum concentrations are elevated in mild and moderate renal failure.  J Am Soc Nephrol. 2002;  13 461-469
    PubMedGoogle Scholar
  • 41 Ezeh B, Haiman M, Alber H F. et al . Plasma distribution of apoA-IV in patients with coronary artery disease and healthy controls.  J Lipid Res. 2003;  44 1523-1529
    PubMedGoogle Scholar
  • 42 Wong W M, Hawe E, Li L K. et al . Apolipoprotein AIV gene variant S347 is associated with increased risk of coronary heart disease and lower plasma apolipoprotein AIV levels.  Circ Res. 2003;  92 969-975
    CrossrefPubMedGoogle Scholar

Florian Kronenberg, MD

Innsbruck Medical University, Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology

Schöpfstraße 41

6020 Innsbruck

Austria

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