Association between erythrocyte mean corpuscular volume and peripheral arterial disease in male subjects - A case control study

Elevated serum total homocysteine, an established risk factor for periphera l arterial disease, is influenced by the vitamin B12 and folate status. Sin ce these vitamins are inversely correlated with erythrocyte mean corpuscula r volume, an investigation of whether mean corpuscular volume is higher in patients with symptomatic peripheral arterial disease than in healthy subje cts was performed. Furthermore, a determination of predictors of increased mean corpuscular volume levels in this population free of symptomatic coron ary artery disease, cerebrovascular disease, and diabetes mellitus was carr ied out. From 469 consecutive patients with symptomatic peripheral arterial disease, 100 fulfilled study inclusion criteria. Peripheral arterial disea se was confirmed by angiography. One hundred age-matched subjects without p eripheral arterial disease as verified by ankle-brachial index measurements >0.9 served as control subjects. Patients with PAD displayed a significant ly higher mean corpuscular volume level (94.5 fl) than control subjects (90 .9fl, p < 0.001). Logistic regression analysis showed that current smoking status (p < 0.001) and mean corpuscular volume (p = 0.009), but not total h omocysteine or lipid parameters discriminated case control status. In addit ion, logistic regression analysis revealed a relationship of mean corpuscul ar volume with smoking (p = 0.001), gamma-glutamyltransferase (p < 0.001), and total homocysteine (p = 0.012). This model predicted mean corpuscular v olume values with an accuracy of 83%. Elevated mean corpuscular volume is a predictor of symptomatic peripheral arterial disease in the sample studied . A deficiency of folate and/or vitamin B12 may be responsible for this obs ervation, as indicated by the correlation of mean corpuscular volume with t otal homocysteine. Due to the additional association of mean corpuscular vo lume with smoking and gamma-glutamyltransferase, an unhealthy lifestyle wit h low vitamin intake may cause elevated mean corpuscular volume values in p atients with PAD.