Fat in muscle hastens limb loss, study shows

For decades, treatment of peripheral artery disease has focused almost exclusively on restoring blood flow.

Now, new research from University of Florida scientists suggests that what happens inside the muscle, not just inside the artery, might determine whether patients regain their strength.

Peripheral artery disease is a vascular illness that affects over 200 million people worldwide, causing leg arteries to constrict — usually due to plaque buildup. As blood flow lessens, patients may suffer leg pain, especially when walking.

Though manageable with early diagnosis, at its worst stage, patients develop chronic limb-threatening ischemia — reduced blood flow that results in precisely what its name suggests: amputation, or limb loss.

Despite recent treatment advances, many patients continue to experience profound muscle weakness even after surgery to open their arteries and restore blood flow.

In a new study published in Circulation, researchers found that the buildup of fat inside skeletal muscle, similar to marbling in a steak, directly affects how well muscles work in patients with advanced peripheral artery disease. This fat marbling, or intramuscular adipose tissue, is more than just an incidental bystander to the vascular disease; it’s also an instigator of limb weakness.

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