Circulating blood markers and functional impairment in peripheral arterial disease

Mary M. McDermott, Kiang Liu, Luigi Ferrucci, Lu Tian, Jack M. Guralnik, David Green, Jin Tan, Yihua Liao, William H. Pearce, Joseph R. Schneider, Kimberly McCue, Paul Ridker, Nader Rifai, Michael H. Criqui

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

Abstract

OBJECTIVES: To determine whether higher levels of inflammatory blood markers, D-dimer, and homocysteine were associated with greater impairment in lower extremity functioning in persons with peripheral arterial disease (PAD). DESIGN: Cross-sectional. SETTING: Three Chicago-area medical centers. PARTICIPANTS: Four hundred twenty-three persons with PAD (ankle-brachial index (ABI) <0.90). MEASUREMENTS: Lower extremity performance was assessed using the 6-minute walk and with usual- and fast-paced 4-m walking speed. Blood markers were D-dimer, C-reactive protein (CRP), interleukin-6 (IL-6), soluble vascular cellular adhesion molecule-1 (sVCAM-1), soluble intracellular adhesion molecule-1 (sICAM-1), and homocysteine. Calf muscle area was measured using computed tomography. RESULTS: Adjusting for confounders, higher levels of D-dimer (P<.001), IL-6 (P<.001), sVCAM-1 (P=.006), CRP (P=.01), homocysteine (P=.004), and sICAM-1 (P=.046) were associated with poorer 6-minute walk performance. Higher levels of D-dimer (P<.001), IL-6 (P=.003), sVCAM-1 (P=.001), and homocysteine (P=.005) were associated with slower usual-paced 4-m walking speed. Higher levels of D-dimer, sVCAM-1, sICAM-1, IL-6, and homocysteine were associated with slower fast-paced walking speed. Results were attenuated after additional adjustment for calf muscle area. CONCLUSION: Higher levels of inflammation and D-dimer were associated with poorer lower extremity performance in participants with PAD, independent of confounders including ABI.

Original languageEnglish (US)
Pages (from-to)1504-1510
Number of pages7
JournalJournal of the American Geriatrics Society
Volume56
Issue number8
DOIs
StatePublished - Aug 2008

Keywords

  • Inflammation
  • Intermittent claudication
  • Peripheral vascular disease
  • Physical functioning

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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