Sunday, 27 October 2013

Obesity and Chronic Venus Insufficiency

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How to calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Chronic venous insufficiency or CVI is defined as a condition of swelling in the veins in the leg due to blood accumulation as result of the veins no longer working effective in pumping oxygen-depleting blood back to the heart.

D. How Obesity associates with Chronic Venus Insufficiency
1. In the examination of 36 limbs in 23 nonobese individuals and 44 limbs in 22 obese individuals of the study of "Impact of obesity on venous hemodynamics of the lower limbs" by Willenberg T, Schumacher A, Amann-Vesti B, Jacomella V, Thalhammer C, Diehm N, Baumgartner I, Husmann M., posted in PubMed, researchers filed the conclusion that Lower limb venous flow parameters differ significantly between healthy obese and nonobese individuals. These findings support the mechanical role of abdominal adipose tissue potentially leading to elevated risk for both venous thromboembolism and chronic venous insufficiency.

2. According to the study of "Obesity and impaired venous function" by van Rij AM, De Alwis CS, Jiang P, Christie RA, Hill GB, Dutton SJ, Thomson IA., posted in PubMed, researchers found that The CEAP clinical stage of venous disease is more advanced in obese patients than non-obese patients with comparable anatomical patterns of venous incompetence. This may be the result of raised intra-abdominal pressure reported in previous studies, leading to greater reflux, increased vein diameter and venous pressures.

3. In the study of "Clinical presentation and patterns of venous reflux in Thai patients with chronic venous insufficiency (CVI)" by Kanchanabat B, Wongmahisorn Y, Stapanavatr W, Kanchanasuttirak P, Manomaiphiboon A., posted in PubMed, the group found that Thai patients with CVI were relatively young. Visible varicose veins, pain, oedema and inflammation were uncommon and most patients could maintain their usual activities despite advanced venous disease. An association with obesity was not common. Despite a low prevalence of a history of previous DVT, the prevalence of deep vein reflux was high and commonly combined with superficial venous reflux.

4. In the observation of 40,095 individuals from 803 registers of primary care in Poland of the study of "The influence of environmental factors in chronic venous insufficiency" by LinkJawien A., posted in PubMed, Jawien A. indicated that in the other developed countries was reported. It was more common in women, but female sex was not found to be a strong risk factor. Among the risk factors most closely associated with CVI were age, family history of varicose veins, and constipation, whatever the sex. This is in keeping with findings from recent epidemiologic studies. Obesity and lack of physical activity were strongly associated with CVI in women, more so than in men.

5. According to the study of "[Influence of environmental risk factors on the development of chronic vein insufficiency]" [Article in Polish] by Sudoł-Szopińska I, Błachowiak K, Koziński P., posted in PubMed, researchers wrote that this paper presents basic information on CVI epidemiology, etiopathogenesis and pathophysiology and also reviews the literature on the following CVI risk factors: obesity, lack of physical activity, dietary habits, including constipation, pregnancy, genetic factors as well as prolonged sedentary or upright position during job performance.

6. Etc.

E. Treatments of Obesity and Chronic Venus Insufficiency
1. According to the study of "In situ hemodynamics of perforating veins in chronic venous insufficiency" by Delis KT, Husmann M, Kalodiki E, Wolfe JH, Nicolaides AN., posted in PubMed, researchers found that In addition to an increase in diameter, perforator incompetence is characterized by significantly higher mean and peak flow velocities, volume flow, and venous volume displaced outward, and a lower flow pulsatility. Differences in early reflux enable a better hemodynamic stratification of incompetent perforators in CVI classes. In the presence of deep reflux, incompetent perforators sustain further hemodynamic impairment. In situ hemodynamics enable quantification of the function of perforators and can be used in the identification of the clinically relevant perforators and the impact of surgery.

2. In the study of "Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity" by Wang SM, Hu ZJ, Li SQ, Huang XL, Ye CS., posted in PubMed, researchers concluded that External valvuloplasty of the femoral vein combined with surgical repair of the superficial venous system improved the hemodynamic status of the lower limbs, restored valvular function more effectively, and achieved better outcomes than surgical repair of the superficial venous system alone.

3. Etc.

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