Metabolic Syndrome Components Found to Raise PAD Risk

WASHINGTON — The metabolic syndrome increases the risk for peripheral arterial disease as well as coronary artery disease, Andy Menke and his associates reported in a poster presented at a conference on cardiovascular disease epidemiology and prevention sponsored by the American Heart Association.

The relationship between the metabolic syndrome and coronary artery disease is well established.

Now, data from 2,175 participants in the 1999–2002 National Health and Nutrition Examination Survey (NHANES) suggest that the association also extends to the peripheral arteries, and in a dose-response fashion—that is, the more metabolic syndrome components a person has, the greater the risk for peripheral arterial disease (PAD), said Mr. Menke, a doctoral student in the department of epidemiology at Tulane University, New Orleans.

A total of 827 participants had metabolic syndrome, defined as the presence of three or more of the following:

▸ Systolic blood pressure readings greater than or equal to 130 mm Hg, and/or diastolic blood pressure greater than or equal to 85 mm Hg, and/or the use of antihypertensive medication.

▸ Serum HDL cholesterol less than 40 mg/dL for men and less than 50 mg/dL for women.

▸ Serum triglyceride level greater than or equal to 150 mg/dL.

▸ Plasma glucose greater than or equal to 110 mg/dL and/or use of insulin or glucose-lowering medication.

▸ Abdominal obesity (waist circumference greater than 102 cm for men and greater than 88 cm for women).

Those with metabolic syndrome were significantly older, had a higher body mass index, and were more likely to have a low glomerular filtration rate.

The age-adjusted prevalence of PAD, defined as the average of the left and right ankle-brachial index being less than 0.9, was present in 5.3% of those with metabolic syndrome and in 3.2% of those without, a significant difference.

After adjustment for BMI, age, race/ethnicity, sex, high school education, physical inactivity, alcohol consumption, glomerular filtration rate, and current/former smoking, subjects with the metabolic syndrome were nearly three times more likely to have PAD than were those who did not.

Those with three metabolic syndrome components had an odds ratio of 1.68 for PAD, compared with subjects who had just one or two components, while the odds ratio for those with four or five components was 1.54.

Among the individual metabolic syndrome components, the subjects with elevated blood pressure had an odds ratio of 1.83 for PAD, compared with those who were normotensive, according to the investigators.

The conference was also sponsored by the National Heart, Lung, and Blood Institute.