Objective To investigate the effect of adult obesity on peripheral arterial disease (PAD) and risk prediction through the physical examination data of 1 448 subjects.

Methods SPSS 26.0, GraphPad Prism 9.2.1, and HIPLOT tool were used for statistics and plotting.Nonlinear fitting curves were used to verify the association between obesity and clinical parameters, while binary and multivariate logistic regression were subjected to predict and assess independent risk factors for PAD.Nomograms and calibration curves were applied to assess the stability and accuracy of multivariate logistic regression prediction models.

Results Obesity was significantly correlated with total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), diastolic blood pressure (DBP), and systolic blood pressure (SBP) (P < 0.05), and performed a linear correlation with brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI).When body mass index (BMI)=31.187 5 kg/m² (P < 0.01) and BMI=36.687 5 kg/m² (P < 0.01), baPWV and ABI reached a maximum, respectively.Controlling for variables such as gender and age, the odds ratios of vascular sclerosis were 1.524 (1.177, 1.974) and 1.532 (1.155, 2.033) in overweight subjects, and 0.233 (0.092, 0.593) and 0.423 (0.149, 1.197) in lean subjects, respectively.Further adjustment for diabetes mellitus, dyslipidemia, and hypertension, results showed that the risk of left limb arterial calcification was first increased and then decreased in obese subjects.Advanced age, male, and the elevation of FPG, blood pressure, TC, and pulse could aggravate the risk of PAD.

Conclusions Hypertension, diabetes mellitus and hyperlipidemia are independent risk factors of PAD.Obesity is an important risk factor for affecting PAD, and obese female have a smaller risk of PAD than overweight male.