Peri-aortic Fat Deposition and It’s Relation with Lower Limb Peripheral Arterial Disease: A CTA-Based Study

Abstract

Introduction: Peripheral artery disease (PAD) is when atherosclerotic plaques narrow the arterial lumen leading to decreased blood flow to the lower limbs. PAD is associated with systemic atherosclerosis and other metabolic risk factors. Peri-aortic fat deposits are associated with increased incidence of PAD, and they can be detected by CTA. The aim of this study is to evaluate the association between peri-aortic fat deposition and lower limb PAD using CTA. Methods: This was a cross-sectional study conducted in Cardiac Center, Erbil, Kurdistan Region of Iraq between June 2024 and January 2025. The sample size included 50 participants who underwent CTA for the evaluation of the abdominal aorta and lower limb arterial system. Data entry and analysis were performed using IBM SPSS (Statistical Package for Social Sciences). Results: Mean periaortic fat area was significantly different between BMI subgroups and in those with dyslipidemia, diabetes mellitus, renal impairment, and IHD compared to patients without these comorbidities. Mean aortic diameter was found to be significantly different between age (p = 0.033) and smoking subgroups (0.006). periaortic fat area (p <0.001, ρ = 0.562) and periaortic fat density (p = 0.001, ρ = 0.473) had significant moderate positive correlations with the degree of the most severe lesion in the lower limbs. Conclusion: Peri-aortic fat measured by CTA was positively correlated with metabolic parameters (HbA1c, serum lipids and creatinine) as well as the severity of peripheral arterial lesions.