Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492011000200006
Jornal Vascular Brasileiro
Original Article

Prevalência de insuficiência venosa superficial dos membros inferiores em pacientes obesos e não obesos

Prevalence of lower limbs superficial venous insufficiency in obese and non-obese patients

Amélia Cristina Seidel; Amanda Sampaio Mangolim; Leandro Pablos Rossetti; Juliana Regina Gomes; Fausto Miranda Jr

http://dx.doi.org/10.1590/S1677-54492011000200006 J Vasc Bras, vol.10, n2, p.124-130, 2011
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Resumo

CONTEXTO: A insuficiência venosa crônica dos membros inferiores é a mais prevalente das doenças venosas. Muito se discute sobre sua etiologia e fisiopatologia. Vários fatores de risco têm sido associados ao seu desenvolvimento, como idade, sexo, dieta, entre outros. A obesidade é um problema de saúde pública e sua incidência tem aumentado. O ecocolor Doppler é um método útil para avaliar a presença de refluxo e/ou obstrução no sistema venoso. OBJETIVO: Comparar a prevalência de insuficiência venosa superficial e sintomas associados em pacientes obesos e não obesos. MÉTODOS: Após pesagem, medição da estatura e exame físico, os pacientes com índice de massa corpórea (IMC) <30 kg/m² e >35 kg/m² e queixas compatíveis com insuficiência venosa foram distribuídos nos grupos I e II, respectivamente. Foram submetidos à realização do ecocolor Doppler dos membros inferiores para avaliação da presença ou não de refluxo. RESULTADOS: Foram examinados 311 membros de 168 pacientes com 25-72 anos. Para análise estatística, foram consideradas queixas de varizes, dor, edema, dermatite, eczema e úlcera, associados ou não. Foi obtido um total de 109 e 104 membros com varizes nos grupos I e II, respectivamente. Queixas de varizes visíveis (p<0,001) e varizes visíveis com dor (p = 0,0118) foram mais prevalentes no grupo I. Queixas de varizes com edema (p<0,001), somente edema (p<0,001) e edema associado a dor (p<0,001) foram mais prevalentes no grupo II. Os dados não mostraram diferença estatisticamente significante na prevalência de varizes entre os grupos I e II. CONCLUSÃO: A prevalência de varizes é semelhante entre os obesos e não obesos; as queixas clínicas diferem entre os grupos e são compatíveis e dependentes da presença de insuficiência venosa.

Palavras-chave

Insuficiência venosa, veia safena, obesidade, extremidade inferior

Abstract

BACKGROUND: Chronic venous insufficiency of the lower limbs is the most prevalent venous disease. There is an ongoing debate about its etiology and pathophysiology. Several risk factors have been associated with its development, such as age, sex and diet. Obesity is a public health problem and its prevalence has been increasing. Color Doppler ultrasonography is a useful method to evaluate the presence of reflux and/or obstruction of the venous system. OBJECTIVE: To compare the prevalence of superficial venous insufficiency and associated symptoms in obese and non-obese patients. METHODS: After weighing, height measurement and physical examination, patients with body mass index (BMI) <30 kg/m² and >35 kg/m² and complaints compatible with venous insufficiency were divided into groups I and II, respectively. They underwent color Doppler ultrasonography of the lower limbs, in order to assess the presence or absence of reflux. RESULTS: A total of 311 limbs of 168 patients 25 to 72 years old were examined. For statistical analysis, complaints of varicose veins, pain, swelling, dermatitis, eczema and ulcers, associated or not, were considered. A total of 109 and 104 limbs with varicose veins were obtained in groups I and II, respectively. The prevalence of visible varicose veins (p<0.001) and visible varicose veins with pain (p=0.0118) was higher in group I. Complaints of varicose veins with edema (p<0.001), only edema (p<0.001) and edema with pain (p<0.001) were more prevalent in group II. Data did not present significant statistical difference in the prevalence of varicose veins between groups I and II. CONCLUSION: The prevalence of varicose veins in obese and non-obese individuals is similar ; clinical complaints differ between groups and are consistent and dependent on the presence of venous insufficiency.

Keywords

Venous insufficiency, saphenous vein, obesity, lower extremity

References

Abu-Own A, Scurr JH, Coleridge Smith PD. Saphenous vein reflux without incompetence at the saphenousfemoral junction. Br J Surg.. 1994;81:1452-4.

Pappas PJ, Lal BK, Cerveira JJ, Padberg FT Jr, Duran WN. Causes of severe chronic venous insufficiency. Semin Vasc Surg.. 2005;18:30-5.

Labropoulos N, Leon LR Jr. Duplex evaluation of venous insufficiency. Semin Vasc Surg.. 2005;18:5-9.

Melissas J, Christodoulakis M, Spyridakis M. Disorders associated with clinically severe obesity: significant improvement after surgical weight reduction. South Med J.. 1998;91:1143-8.

Buchwald H. Overview of bariatric surgery. J Am Coll Surg.. 2002;194:367-75.

Bergan JJ, Pascarella L. Severe Chronic venous insufficiency: primary treatment with sclerofoam. Semin Vasc Surg.. 2005;18:49-56.

Callam MJ. Epidemiology of varicose veins. Br J Surg.. 1994;81:167-73.

Ageno W, Piantanida E, Dentali F. Body mass index is associated with the development of the post-thrombotic syndrome. Thromb Haemost.. 2003;89:305-9.

Jawien A. The influence of environmental factors in chronic venous insufficiency. Angiology.. 2003;54:S19-31.

Douketis JD, Paradis G, Keller H, Martineau C. Canadian guidelines for body weight classification in adults: application in clinical practice to screen for overweight and obesity and to assess disease risk. CMAJ.. 2005;172:995-8.

Iannuzzi A, Panico S, Ciardullo A. Varicose veins of the lower limbs and venous capacitance in postmenopausal women: relationship with obesity. J Vasc Surg.. 2002;36:965-8.

Beebe-Dimmer JL, Pfeifer JR, Engle JS, Schottenfeld D. The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol.. 2005;15:175-84.

Fowkes FGR, Lee AJ, Evans CJ, Allan PL, Bradbury AW, Ruckley CV. Lifestyle risk factors for lower limb venous reflux in the general population: Edinburgh Vein Study. Int J Epidemiol.. 2001;30:846-52.

Lionis C, Erevnidou K, Argyriadou S, Vlachonikolis I, Katsamouris A, Antonakis N. Chronic venous insufficiency. A common health problem in general practice in Grecce. Int Angiol.. 2002;21:86-92.

Ruckley CV, Evans CJ, Allan PL, Lee AJ, Fowkes FGR. Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. J Vasc Surg.. 2002;36:520-5.

Raju N, Neglén P. Chronic Venous Insufficiency and Varicose Veins. N Engl J Med.. 2009;360:2319-27.

Safar H, Shawa N, Al-Ali J, Al-Nassar M, Dashti H, Asfar S. Is there a need for Doppler vascular examination for the diagnosis of varicose vein? A prospective study. Med Princ Pract.. 2004;13:43-6.

van Bemmelen PS, Bedford G, Beach K, Strandness DE. Quantitative segmental evaluation of venous valvular reflux with duplex ultrasound scanning. J Vasc Surg.. 1989;10:425-31.

Fowkes FGR, Evans CJ, Lee AJ. Prevalence and risk factors of chronic venous insufficiency. Angiology.. 2001;52:S5-S15.

Kurz X, Kahn SR, Abenhaim L. Chronic venous disorders of the leg: epidemiology, outcomes, diagnosis and management. Summary of an evidence-based report of the VEINES task force. Venous Insufficiency Epidemiologic and Economic Studies. Int Angiol.. 1999;18:83-102.

Sugerman HJ, Sugerman EL, Wolfe L. Risks and benefits of gastric bypass in morbidly obese patients with severe venous stasis disease. Ann Surg.. 2001;234:41-6.

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;37:79-85.

Porter JM, Moneta GL. Reporting standards in venous disease: an update. International Consensus Committee on Chronic Venous Disease. J Vasc Surg.. 1995;21:635-45.

van Rij AM, De Alwis CS, Jiang P. Obesity and impaired venous function. Eur J Vasc Endovasc Surg.. 2008;35:739-44.

Danielsson G, Eklof B, Grandinetti A, Kistner RL. The influence of obesity on chronic venous disease. Vasc Endovascular Surg.. 2002;36:271-6.

Scott TE, LaMorte WW, Gorin DR, Menzoian JO. Risk factor for chronic venous insufficiency: a dual case-control study. J Vasc Surg.. 1995;22:622-8.

Brand FN, Dannenberg AL, Abbott RD, Kannell WB. The epidemiology of varicose veins: the Framingham study. Am J Prev Med.. 1988;4:96-101.

Evans CJ, Fowkes FGR, Ruckley CV, Lee AJ. Prevalence of varicose vein and chronic venous insufficiency in men and women in the general population: Edinburg Vein Study. J Epidemiol Community Health.. 1999;53:149-53.

Mekky S, Schilling RSF, Walford J. Varicose veins in women cotton workers. An epidemiological study in England and Egypt. Br Med J.. 1969;2:591-5.

Sisto T, Reunanen A, Laurikka J. Prevalence and risk factors of varicose veins in lower extremities: mini-Finland health survey. Eur J Surg.. 1995;161:405-14.

Seidell JC, de Groot L, van Sonsbeek JL, Deurenberg P, Hautvast J. Associations of moderate and severe overweight with self-reported illness and medical care in Dutch adults. Am J Public Health.. 1986;76:264-9.

Seidell JC, Bakx KC, Deurenberg P, van den Hoogen H, Hautvast J, Stijnen T. Overweight and chronic illness--a retrospective cohort study, with a follow-up of 6-17 years, in men and women of initially 20-50 years of age. J Chronic Dis.. 1986;39:585-93.

van Noord PA, Seidell JC, den Tonkelaar I, Baanders-van Halewijn EA, Ouwehand IJ. The relationship between fat distribuition and some chronic disease in 11,825 women participating in the DOM-project. Int J Epidemiol.. 1990;19:564-70.

Stanhope JM. Varicose veins in a population of lowland New Guinea. Int J Epidemiol.. 1975;4:221-5.

Malhotra SL. An epidemiological study of varicose veins in Indian railroad workers from the South and North of India, with special reference to the causation and prevention of varicose veins. Int J Epidemiol.. 1972;1:177-83.

Robertson L, Evans C, Fowkes FG. Epidemiology of chronic venous disease. Phlebology.. 2008;23:103-11.

Kostas TI, Ioannou CV, Drygiannakis I. Chronic venous disease progression and modification of predisposing factors. J Vasc Surg.. 2010;51:900-7.

Lemaire R. The flow of venous blood in the obese. Phebologie.. 1988;41:493-9.

Pitta GBB. Cirurgia de varizes na obesidade. Angiologia e cirurgia vascular: guia ilustrado. 2003.

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