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The effect of obesity on venous impedance and outflow measured by ultrasound

Wall, Michael Lewis (2011)
M.D. thesis, University of Birmingham.

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Obesity has been identified epidemiologically as a risk factor for development of chronic venous disease. To examine whether abdominal adiposity obstructs venous outflow from the legs, 26 females aged 34-49 years with no clinical venous disease and body mass index (BMI) between 20.9 – 46.7 kg/m\(^2\) were studied. A novel measurement of the extent of abdominal fat along the legs when seated correlated well with BMI and other measures of central fat (sagittal-abdominal diameter, ultrasound fat thickness, % truncal fat by DEXA scan). On sitting, inguinal tissue pressure recorded by needle manometry increased more in obese (BMI > 30) than normal weight (BMI 20-25) subjects (8.2 vs 1.5 mmHg, p<0.01) as did the femoral vein cross-sectional area (129 vs 60%, p<0.05). Both measures correlated with increasing abdominal fat but were not associated with each other. In the lower leg, saphenous vein distensibility and compliance correlated positively with abdominal fat and BMI, but there was no such association for the popliteal vein. Female sex hormones, physical activity levels and insulin status did not affect venous haemodynamics. Thus, increased abdominal fat can potentially hinder venous return when sitting, leading to distension and changes in vein biomechanics, which could over time contribute to venous disease.

Type of Work:M.D. thesis.
Supervisor(s):Brown, Margaret
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:Department of Medicine
Subjects:R Medicine (General)
RA Public aspects of medicine
RA0421 Public health. Hygiene. Preventive Medicine
Institution:University of Birmingham
ID Code:2971
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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