title: Hemorheology, ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) in metabolic syndrome.
abstract: BACKGROUND
  Microvascular dysfunction is associated with metabolic syndrome (MetS) and its components. The objective of our study was to assess macro and microvascular abnormalities in MetS and compare the strength of association of the ankle brachial pressure index (ABPI), toe brachial pressure index (TBPI) and hemorheological parameters with MetS.
  
  
  METHODS
  100 participants were recruited from a rural Australian town. Anthropometric measurements were taken along with blood pressures (BP) at the arm, the ankle and the big toe for calculating ABPI and TBPI. Whole blood viscosity (WBV), erythrocyte aggregation, erythrocyte deformability, lipid profile and blood sugar level were analyzed. Recruited participants were classified into MetS and non-MetS following National Cholesterol Education Program Adult Treatment Panel III definition. Data were analyzed by IBM SPSS 20 software.
  
  
  RESULTS
  WBV and erythrocyte aggregation were higher whereas erythrocyte deformability was lower in participants with MetS when compared to participants without MetS. Age, sex and diabetes mellitus adjusted odds ratio for predicting MetS was not significant for ABPI and TBPI whereas it was significant for hemorheological parameters. Receiver Operating Characteristics curve showed that TBPI better classified MetS than ABPI but association of hemorheological parameters was superior to that of ABPI and TBPI with MetS.
  
  
  CONCLUSIONS
  Both microcirculation defects and macrovascular circulation defects were present in MetS. The concurrences of the components of MetS could have an additive effect in enhancing alterations in hemorheological parameters which may give rise to severe microvasculopathy. The association of hemorheological parameters was stronger than the association of TBPI and ABPI with MetS.
authors.affiliation: Biomedical Sciences, School of Community Health, Charles Sturt University, Australia. Electronic address: clbioprajwal@gmail.com.
authors.forename: Prajwal
authors.initials: P
authors.lastname: Gyawali
authors.affiliation: Biomedical Sciences, School of Community Health, Charles Sturt University, Australia. Electronic address: rorichards@csu.edu.au.
authors.forename: Ross S
authors.initials: RS
authors.lastname: Richards
authors.affiliation: Podiatry, School of Community Health, Charles Sturt University, Australia. Electronic address: ptinley@csu.edu.au.
authors.forename: Paul
authors.initials: P
authors.lastname: Tinley
authors.affiliation: Biomedical Sciences, School of Community Health, Charles Sturt University, Australia. Electronic address: enwose@csu.edu.au.
authors.forename: Ezekiel Uba
authors.initials: EU
authors.lastname: Nwose
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001809:Blood Viscosity; D001810:Blood Volume; D016022:Case-Control Studies; D004903:Erythrocyte Aggregation; D004907:Erythrocyte Deformability; D004909:Erythrocyte Indices; D005260:Female; D018056:Hemorheology; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D008833:Microcirculation; D008875:Middle Aged; D009517:New South Wales; D011237:Predictive Value of Tests; D012423:Rural Health
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids
keywords: ABPI; Cardiovascular disease; Diabetes mellitus; Erythrocyte aggregation; Erythrocyte deformability; Hemorheology; Metabolic syndrome; Microcirculation; TBPI; Whole blood viscosity