Abstract
Introduction and background: Non-communicable diseases (NCD) are a substantial health problem globally, but also nationally with cardiovascular diseases (CVD) currently accounting for every 3rd death in Norway. Peripheral arterial disease (PAD) is a CVD in which a gradual narrowing of peripheral arteries in the lower extremities takes place. PAD is associated with a number of traditional risk factors for atherosclerosis, including smoking, diabetes and dyslipidemia (1). Ankle-brachial index (ABI) is considered an effective, non-invasive and low-cost diagnostic tool for PAD. Dyslipidemia and atherosclerosis are risk factors for PAD, subjecting individuals with familial hypercholesterolemia (FH) to a higher risk for developing PAD. Recent studies have found that 60 – 75% of the FH population with PAD does not display classic symptoms of PAD such as intermittent claudication (IC) (2, 3). Asymptomatic individuals with FH are not routinely assessed for PAD, which raise a concern as to how many asymptomatic individuals with FH that are not receiving the necessary treatment to stop the progression of atherosclerosis. Objectives: This study aimed to explore the possible differences in ABI when comparing a group of FH patients to a group of non-FH patients. We also sought to assess risk factors associated with ABI and to evaluate the use of ABI as a diagnostic tool in a clinical outpatient setting. Materials and methods: From October 2020 to January 2021, 86 participants scheduled for physical consultation at the Lipid clinic at Aker hospital in Oslo were included in this study. ABI was measured to assess circulation in peripheral arteries. Information on anthropometrics, biochemical data and medications were collected from medical records. The data was analyzed using descriptive analysis and linear regression. All data was analyzed using IBM SPSS statistics version 27. Results: We found no statistically significant differences in ABI when comparing a group of FH patients to a group of non-FH patients. We found that HbA1c, premature CVD and antihypertensives were negatively associated with ABI among all the patients. Triglyceride levels (TAG) was negatively associated with ABI measured on the right side only. High-density lipoprotein (HDL) cholesterol was positively associated with ABI in all patients after adjusting for age and gender. Conclusion: We found no statistically significant differences in ABI when comparing a FH group to a non-FH group. ABI was found to be a useful diagnostic tool for the assessment of PAD in an outpatient setting.