Jonathan T Unkart1, Matthew A Allison2, Humberto Parada3, Michael H Criqui2, Qibin Qi4, Keith M Diaz5, Jordan A Carlson6, Daniela Sotres-Alvarez7, Robert J Ostfeld4, Leopoldo Raij8, John Bellettiere2. 1. University of California San Diego, La Jolla, CA, USA. Electronic address: junkart@ucsd.edu. 2. University of California San Diego, La Jolla, CA, USA. 3. San Diego State University, San Diego, CA, USA. 4. Einstein College of Medicine, Bronx, NY, USA. 5. Columbia University Medical Center, New York, NY, USA. 6. Children's Mercy Kansas City, Kansas City, MO, USA. 7. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 8. University of Miami Miller School of Medicine, Miami, FL, USA.
Abstract
BACKGROUND: Experimental evidence suggests that sedentary time (ST) may contribute to cardiovascular disease by eliciting detrimental hemodynamic changes in the lower limbs. However, little is known about objectively measured ST and lower extremity peripheral artery disease (PAD). METHODS: We included 7,609 Hispanic/Latinos (ages 45-74) from the Hispanic Community Health Study/Study of Latinos. PAD was measured using the ankle brachial index (≤0.9). ST was measured using accelerometry. We used multivariable logistic regression to assess associations of quartiles of ST and PAD, and then used the same logistic models with restricted cubic splines to investigate continuous nonlinear associations of ST and PAD. Models were sequentially adjusted for traditional PAD risk factors, leg pain, and moderate- to vigorous-intensity physical activity (MVPA). RESULTS: Median ST was 12.2 h/d, and 5.4% of individuals had PAD. In fully adjusted restricted cubic splines models accounting for traditional PAD risk factors, leg pain, and MVPA, ST had a significant overall (P = .048) and nonlinear (P = .024) association with PAD. A threshold effect was seen such that time spent above median ST was associated with higher odds of PAD. That is, compared to median ST, 1, 2, and 3 hours above median ST were associated with a PAD odds ratio of 1.16 (95% CI = 1.02-1.31), 1.44 (1.06-1.94), and 1.80 (1.11-2.90), respectively. CONCLUSIONS: Among Hispanic/Latino adults, ST was associated with higher odds of PAD, independent of leg pain, MVPA, and traditional PAD risk factors. Notably, we observed a threshold effect such that these associations were only observed at the highest levels of ST.
BACKGROUND: Experimental evidence suggests that sedentary time (ST) may contribute to cardiovascular disease by eliciting detrimental hemodynamic changes in the lower limbs. However, little is known about objectively measured ST and lower extremity peripheral artery disease (PAD). METHODS: We included 7,609 Hispanic/Latinos (ages 45-74) from the Hispanic Community Health Study/Study of Latinos. PAD was measured using the ankle brachial index (≤0.9). ST was measured using accelerometry. We used multivariable logistic regression to assess associations of quartiles of ST and PAD, and then used the same logistic models with restricted cubic splines to investigate continuous nonlinear associations of ST and PAD. Models were sequentially adjusted for traditional PAD risk factors, leg pain, and moderate- to vigorous-intensity physical activity (MVPA). RESULTS: Median ST was 12.2 h/d, and 5.4% of individuals had PAD. In fully adjusted restricted cubic splines models accounting for traditional PAD risk factors, leg pain, and MVPA, ST had a significant overall (P = .048) and nonlinear (P = .024) association with PAD. A threshold effect was seen such that time spent above median ST was associated with higher odds of PAD. That is, compared to median ST, 1, 2, and 3 hours above median ST were associated with a PAD odds ratio of 1.16 (95% CI = 1.02-1.31), 1.44 (1.06-1.94), and 1.80 (1.11-2.90), respectively. CONCLUSIONS: Among Hispanic/Latino adults, ST was associated with higher odds of PAD, independent of leg pain, MVPA, and traditional PAD risk factors. Notably, we observed a threshold effect such that these associations were only observed at the highest levels of ST.
Authors: Anna Maria Siega-Riz; Daniela Sotres-Alvarez; Guadalupe X Ayala; Mindy Ginsberg; John H Himes; Kiang Liu; Catherine M Loria; Yasmin Mossavar-Rahmani; Cheryl L Rock; Brendaly Rodriguez; Marc D Gellman; Linda Van Horn Journal: Am J Clin Nutr Date: 2014-04-23 Impact factor: 7.045
Authors: Genevieve N Healy; Charles E Matthews; David W Dunstan; Elisabeth A H Winkler; Neville Owen Journal: Eur Heart J Date: 2011-01-11 Impact factor: 29.983
Authors: Victor Aboyans; Michael H Criqui; Pierre Abraham; Matthew A Allison; Mark A Creager; Curt Diehm; F Gerry R Fowkes; William R Hiatt; Björn Jönsson; Philippe Lacroix; Benôit Marin; Mary M McDermott; Lars Norgren; Reena L Pande; Pierre-Marie Preux; H E Jelle Stoffers; Diane Treat-Jacobson Journal: Circulation Date: 2012-11-16 Impact factor: 29.690
Authors: Sarah Kozey Keadle; Eric J Shiroma; Masamitsu Kamada; Charles E Matthews; Tamara B Harris; I-Min Lee Journal: Am J Prev Med Date: 2017-01-03 Impact factor: 5.043
Authors: M M McDermott; P Greenland; K Liu; J M Guralnik; M H Criqui; N C Dolan; C Chan; L Celic; W H Pearce; J R Schneider; L Sharma; E Clark; D Gibson; G J Martin Journal: JAMA Date: 2001-10-03 Impact factor: 56.272
Authors: Qibin Qi; Garrett Strizich; Gina Merchant; Daniela Sotres-Alvarez; Christina Buelna; Sheila F Castañeda; Linda C Gallo; Jianwen Cai; Marc D Gellman; Carmen R Isasi; Ashley E Moncrieft; Lisa Sanchez-Johnsen; Neil Schneiderman; Robert C Kaplan Journal: Circulation Date: 2015-09-28 Impact factor: 29.690