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Body mass index and skin changes in patients with venous insufficiecy

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    According to a study done by Danielsson, Eklof and Grandinetti, overweight patients are more likely to have skin changes and ulceration (p < 0.001) than patients with a body mass index less than 25 kg/m2 (BMI < 25)  despite similar values for total (venous)reflux time and total peak reverse flow velocity.

    The authors investigated the impact of overweight in patients with chronic venous disease to determine if the eventual effect can be explained by increased venous reflux alone. Patients with chronic venous disease who underwent duplex-ultrasound scanning were classified according to the clinical, etiologic, anatomic, and pathophysiologic (CEAP) system.  Body mass index (kg/M
    2) was calculated. Reflux duration was measured in seconds and peak reverse flow velocity in cm/second.

    The correlation of body mass index with clinical severity independent of reflux measurements indicates that the effect of overweight may involve a mechanism separate from local effects on venous flow. Overweight appears to be a separate risk factor for increased severity of skin changes in patients with chronic venous disease.

    What are these skin changes?  hyperpigmentation, venous stasis dermatitis. lipodermatosclerosis and venous stasis ulcer formation. 

    Danielsson G, Eklof B, Grandinetti A et al.  The influence of obesity on chronic venous disease.  Vasc Rndovascular Surg 2002: 36: 271-276.