The association between body mass index and lower extremity deep venous abnormalities identified by computed tomography venography.

OBJECTIVE

To investigate the association between body mass index (BMI) and lower-extremity deep venous (LEDV) abnormalities, including thrombosis and stenosis, identified by computed tomography venography (CTV), with analysis on sex-specific patterns and the influence of hypertension, diabetes, and hyperlipidemia.

METHODS

This retrospective cross-sectional study analyzed 349 patients (217 males, 132 females) undergoing CTV. Patients were stratified by sex, age, BMI, and comorbidities (hypertension, diabetes, hyperlipidemia). The per-patient counts of thrombosis and stenosis were compared using t-tests. Multivariable logistic regression (reporting adjusted odds ratios) and negative binomial regression (reporting adjusted incidence rate ratios) were used to assess the independent associations of BMI with LEDV prevalence and lesion burden, adjusting for age, sex, comorbidities, and major venous thromboembolism risk factors. The threshold for statistical significance was set at P < 0.05.

RESULTS

Overweight or obesity was highly prevalent among patients with LEDV abnormalities (86.4% of males, 79.0% of females). Males had more LEDV stenoses than females (1.19 vs. 0.77 per person, P < 0.05). In females, coexisting overweight/obesity with hypertension, diabetes, and/or hyperlipidemia was associated with higher thrombosis prevalence (P < 0.05), which was not observed in males; for stenosis, this comorbidity effect was present in both sexes and more pronounced in males. In multivariable logistic regression, no factor, including BMI was independently associated with LEDV prevalence (all P > 0.05). By negative binomial regression, male sex was independently associated with greater stenosis count (aIRR 1.65, 95% CI 1.19-2.28, P = 0.002) and overall lesion burden (aIRR 1.32, P = 0.048); hypertension was borderline (aIRR 1.39, P = 0.05); BMI was not.

CONCLUSION

Higher BMI was associated with a greater prevalence of CTV-detected LEDV abnormalities, particularly stenosis and in the presence of comorbidities. After multivariable adjustment, however, BMI was not an independent predictor; male sex was the principal independent correlate of stenosis burden, with hypertension borderline. These cross-sectional associations are hypothesis-generating.