The Influence of Body Mass Index on Lower Extremity Vein Diameters at Different Levels in Healthy Population
Abstract
Background: To investigate changes in the size of the deep and superficial venous systems associated with body mass index (BMI), gender, age, in patients without venous insufficiency including the effects of posture.
Methods: Healthy individuals who had no previous diagnosis of venous insufficiency were evaluated with an ultrasound device with a duplex option. The left and right deep and superficial venous systems were scanned both supine and upright positions by the same two radiologists. All clinical findings, BMI and age were recorded for each subject.
Results: Two-hundred ninety-eight patients were included in the study. The patients’ mean age and BMI were 49.94 ±13.19 years (range 19-76), BMI was 24.91±4.0 kg/m² (range 18-38) respectively. The difference between upright and supine positions vein diameters were statistically significant (p<0.01). There were no significant differences between overweight and normal participants in terms of femoral and saphenous vein diameters (p>0.05). The proximal diameter of the great saphenous vein was significantly lower in overweight patients (Table 2). When the patients were analyzed according to BMIs the right femoral vein diameters, the diameters of proximal part and distal two parts of the right great saphenous vein, and left proximal small saphenous vein diameters were significantly higher in patients whose BMI values were between 35-39.99 (obese-class II) (p<0.001).
Conclusions: In conclusion we found both lower limbs’ vein diameters were significantly larger in upright position either superficial and deep systems, however the relationship between age and BMI was not significant. Further longitudinal studies are needed to clarify the influence of anatomic variances in subjects with obese healthy veins.
Keywords
Chronic Venous Disease, Risk Factors, Age, Obesity, Lower Extremity, Vein Diameter.
References
- 1. Robertson L, Evans C, Fowkes FG. Epidemiology of chronic venous disease. Phlebology. 2008;23(3):103-11.
- 2. Chiesa R, Marone EM, Limoni C, Volontè M, Petrini O. Chronic venous disorders: correlation between visible signs, symptoms, and presence of functional disease. J Vasc Surg. 2007;46(2):322-30.
- 3. Darvall KA, Sam RC, Silverman SH, Bradbury AW, Adam DJ. Obesityand thrombosis. Eur J Vasc Endovasc Surg. 2007;33(2):223-33.
- 4. Padberg F Jr, Cerveira JJ, Lal BK, Pappas PJ, Varma S, Hobson RW 2nd. Does severe venous insufficiency have a different etiology in the morbidly obese? Is it venous? J Vasc Surg. 2003;37(1):79-85.
- 5. Arfvidsson B, Eklof B, Balfour J. Iliofemoral venous pressure correlates with intraabdominal pressure in morbidly obese patients. Vasc Endovascular Surg. 2005;39(6):505-9.
- 6. Kröger K, Ose C, Rudofsky G, Roesener J, Weiland D, Hirche H. Peripheral veins: influence of gender, body mass index, age and varicose veins on cross-sectional area. Vasc Med. 2003;8(4):249-55.
- 7. Keiler J, Schulze M, Claassen H, Wree A. Human femoral vein diameter and topography of valves and tributaries: A post mortem analysis. Clin Anat. 2018;31(7):1065-1076.
- 8. WHO. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253.
- 9. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63.
- 10. Adhikari A, Criqui MH, Wooll V, Denenberg JO, Fronek A, Langer RD, et al. The epidemiology of chronic venous diseases. Phlebology. 2000;15(1):2-18.