Diabetes Is Negatively Associated With Meeting Physical Activity Time-intensity Guidelines In Patients With Claudication

Abstract

PURPOSE: We determined the percentage of patients with peripheral artery disease (PAD) and claudication who meet the 2018 physical activity time-intensity guidelines, and we identified the clinical characteristics associated with the status of meeting the guidelines. METHODS: Five hundred seventy-two patients were assessed on their daily ambulatory activity for one week with a step activity monitor, and were evaluated on whether they achieved less than 150 minutes of moderate intensity physical activity per week, or whether they were above this threshold. Patients were also evaluated on demographic and clinical characteristics, as well as ankle/brachial index and ambulatory function. RESULTS: Thirty-one percent (n = 175) of the PAD patients met the physical activity time-intensity guidelines and 69% (n = 397) did not. The respective groups were significantly different on ankle/brachial index (0.75 ± 0.22 vs. 0.65 ± 0.22; p < 0.001; means±SD); 6-minute walk distance (m) (415 ± 79 vs. 335 ± 88; p < 0.001); and prevalence of diabetes (24.0% vs. 50.4%; p < 0.001), metabolic syndrome (74.3% vs. 84.1%; p = 0.008), and dyslipidemia (83.4% vs. 93.0%; p = 0.001). In multivariable logistic regression models evaluating the association between meeting the physical activity time-intensity guidelines and each clinical characteristic, diabetes (odds ratio [OR] = 0.298; 95% CI: 0.175, 0.499; p < 0.001), metabolic syndrome (OR = 0.455; 95% CI: 0.255, 0.811; p = 0.007) and dyslipidemia (OR = 0.467; 95% CI: 0.225, 0.964; p = 0.039) were significantly associated with a lower chance of meeting the guidelines. CONCLUSIONS: Thirty-one percent of patients with PAD and claudication met the physical activity time-intensity guidelines. Furthermore, patients with diabetes, metabolic syndrome, and dyslipidemia were least likely to meet the physical activity time-intensity guidelines. Diabetes was particularly detrimental, as patients with diabetes were 71% less likely to meet the physical activity time-intensity guidelines than patients without diabetes. The clinical significance is that PAD patients who have diabetes are particularly susceptible to being physically sedentary, and are therefore prime patients who should be encouraged to increase their daily physical activity. Supported by NIH (R01-AG-24296 and R01-AG-16685).