The metabolic syndrome is associated with advanced vascular damage in patients with coronary heart disease, stroke, peripheral arterial disease or abdominal aortic aneurysm.
OBJECTIVE
The metabolic syndrome is associated with an increased risk of cardiovascular disease in patients without a cardiovascular history. We investigated whether the metabolic syndrome is related to the extent of vascular damage in patients with various manifestations of vascular disease.


RESULTS
The study population of this cross-sectional survey consisted of 502 patients recently diagnosed with coronary heart disease (CHD), 236 with stroke, 218 with peripheral arterial disease (PAD) and 89 with abdominal aortic aneurysm (AAA). Metabolic syndrome was diagnosed according to Adult Treatment Panel III criteria. Carotid Intima Media Thickness (IMT), Ankle Brachial Pressure Index (ABPI) and albuminuria were used as non-invasive markers of vascular damage and adjusted for age and sex if appropriate. The prevalence of the metabolic syndrome in the study population was 45%. In PAD patients this was 57%; in CHD patients 40%, in stroke patients 43% and in AAA patients 45%. Patients with the metabolic syndrome had an increased mean IMT (0.98 vs 0.92mm, P-value <0.01), more often a decreased ABPI (14% vs 10%, P-value 0.06) and increased prevalence of albuminuria (20% vs 15%, P-value 0.03) compared to patients without this syndrome. An increase in the number of components of the metabolic syndrome was associated with an increase in mean IMT (P-value for trend <0.001), lower ABPI (P-value for trend <0.01) and higher prevalence albuminuria (P-value for trend <0.01).


CONCLUSIONS
In patients with manifest vascular disease the presence of the metabolic syndrome is associated with advanced vascular damage.
Internal Medicine, Section of Vascular Medicine, UMC Utrecht, Utrecht, The Netherlands. J.K.Olijhoek@azu.nl
Jobien K
JK
Olijhoek
Yolanda
Y
van der Graaf
Jan-Dirk
JD
Banga
Ale
A
Algra
Ton J
TJ
Rabelink
Frank L J
FL
Visseren
D017544:Aortic Aneurysm, Abdominal / Q000209:etiology* / Q000473:pathology; D003327:Coronary Disease / Q000209:etiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000473:pathology; D011379:Prognosis; D020521:Stroke / Q000209:etiology* / Q000473:pathology; D017539:Tunica Intima / Q000473:pathology