Evaluating the Relation between Metabolic Syndrome and its Components with Low Ankle to Brachial Index in an Iranian Population

Document Type : Original Article (s)

Authors

1 Resident, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Associate Professor, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Department of Cardiology,Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Assistant Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

5 Researcher, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

6 Professor, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Department of Cardiology,Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: This study was conducted to determine the relationship between metabolic syndrome and ankle to brachial index (ABI).Methods: This study is a part of Isfahan Cohort study that was conducted in 2009 in 132 patients with and with ought metabolic syndrome. Waist circumference, weight, height, blood pressure and ABI were measured in decubites position by Echo Doppler. Glucose, total cholesterol, HDL, LDL cholesterol, HDL cholesterol and triglycerides were measured. The relationship between ABI and metabolic syndrome was assessed by logistic regression.Finding: From 264 participants, in above 60 years old, in hypertensive patients, ABI was lower in patients with metabolic syndrome than patients without it. Our results showed that low ABI and hypertension had significant relationship in subjects with metabolic syndrome (P < 0.001).Conclusion: ABI was lower in subjects with metabolic syndrome. It was significantly related to hypertension in subjects with metabolic syndrome. Therefore measurement of ABI in patients with metabolic syndrome could be useful to determine subclinical atherosclerosis in them.

Keywords


  1. Jago R, Baranowski T, Buse J, Edelstein S, Galassetti P, Harrell J, et al. Prevalence of the metabolic syndrome among a racially/ethnically diverse group of U.S. eighth-grade adolescents and associations with fasting insulin and homeostasis model assessment of insulin resistance levels. Diabetes Care 2008; 31(10): 2020-5.
  2. Sarrafzadegan N, Kelishadi R, Baghaei A, Hussein SG, Malekafzali H, Mohammadifard N, et al. Metabolic syndrome: an emerging public health problem in Iranian women: Isfahan Healthy Heart Program. Int J Cardiol 2008; 131(1): 90-6.
  3. Tavassoli AA, Gharipour M, Khosravi A, Keli-shadi R, Dana Siadat Z, Bahonar A, et al. Gender differences in obesogenic behaviour, socioeconomic and metabolic factors in a population based sample of Iranians: The IHHP Study.J Health Popul Nutr 2010; 28(6): 602-9.
  4. Gharipour M, Kelishadi R, Baghaie M, Rabiei K. Metabolic syndrome in an Iranian adult population. Europ Heart J 2006; 27(Suppl): 250-1.
  5. Sarraf-Zadegan N, Sadri G, Malek Afzali H, Baghaei M, Mohammadi Fard N, Shahrokhi S, et al. Isfahan Healthy Heart Program: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience. Acta Cardiol 2003; 58(4): 309-20.
  6. Lee AJ, Price JF, Russell MJ, Smith FB, van Wijk MC, Fowkes FG. Improved prediction of fatal myocardial infarction using the ankle brachial index in addition to conventional risk factors: the Edinburgh Artery Study. Circulation 2004; 110(19): 3075-80.
  7. Vogt MT, McKenna M, Wolfson SK, Kuller LH. The relationship between ankle brachial index, other atherosclerotic disease, diabetes, smoking and mortality in older men and women. Atherosclerosis 1993; 101(2): 191–202.
  8. Lahoz C, Vicente I, Laguna F, Garcia-Iglesias MF, Taboada M, Mostaza JM. Metabolic syn-drome and asymptomatic peripheral artery disease in subjects over 60 years of age. Diabetes Care 2006; 29(1): 148-50.
  9. Wyman RA, Keevil JG, Busse KL, Aeschlimann SE, Korcarz CE, Stein JH. Is the ankle-brachial index a useful screening test for subclinical atherosclerosis in asymptomatic, middle-aged adults? WMJ 2006; 105(6): 50-4.
  10. Xu Y, Li J, Luo Y, Wu Y, Zheng L, Yu J, et al. The association between ankle-brachial index and cardiovascular or all-cause mortality in metabolic syndrome of elderly Chinese. Hypertens Res 2007; 30(7): 613-9.
  11. Criqui MH, Ninomiya JK, Wingard DL, Ji M, Fronek A. Progression of peripheral arterial disease predicts cardiovascular disease morbidity and mortality. J Am Coll Cardiol 2008; 52(21): 1736-42.
  12. Dhuper S, Cohen HW, Daniel J, Gumidyala P, Agarwalla V, St Victor R, et al. Utility of the modified ATP III defined metabolic syndrome and severe obesity as predictors of insulin re-sistance in overweight children and adolescents: a cross-sectional study. Cardiovasc Diabetol 2007; 6: 4.
  13. Shirani S, Kelishadi R, Sarrafzadegan N, Khosravi A, Sadri G, Amani A, et al. Awareness, treatment and control of hypertension, dyslipidaemia and diabetes mellitus in an Iranian population: the IHHP study. East Mediterr Health J 2009; 15(6): 1455-63.
  14. Olijhoek JK, van der Graaf Y, Banga JD, Algra A, Rabelink TJ, Visseren FL. The metabolic syndrome is associated with advanced vascular damage in patients with coronary heart disease, stroke, peripheral arterial disease or abdominal aortic aneurysm. Eur Heart J 2004; 25(4): 342-8.
  15. Suarez C, Manzano L, Mostaza J, Cairols M, Palma JC, Garcia I, et al. Prevalence of peripheral artery disease evaluated by ankle brachial index in patients with metabolic syndrome. MERITO I study. Rev Clin Esp 2007; 207(5): 228-33. [In Spanish].
  16. Lopez-Suarez A, Beltran-Robles M, Elvira-Gonzalez J, Alwakil M, Bascuñana-Quirell A, Rosal-Obrador J, et al. Does diagnosis of metabolic syndrome predict the likelihood of peripheral arterial disease as defined by a low ankle-brachial index? Eur J Cardiovasc Prev Rehabil 2008; 15(6): 693-7.
  17. Li J, Luo Y, Xu Y, Yang J, Zheng L, Hasimu B, et al. Risk factors of peripheral arterial disease and relationship between low ankle - brachial index and mortality from all-cause and cardiovascular disease in Chinese patients with type 2 diabetes. Circ J 2007; 71(3): 377-81.
  18. Hasimu B, Li J, Nakayama T, Yu J, Yang J, Li X, et al. Ankle brachial index as a marker of atherosclerosis in Chinese patients with high cardiovascular risk. Hypertens Res 2006; 29(1): 23-8.
  19. Xu Y, Li J, Luo YY, Li MJ, Zhang JM, Xing Y, et al. The relationship between ankle brachial index and all-cause and cardiovascular disease mortality in Chinese metabolic syndrome male cohort. Zhonghua Nei Ke Za Zhi 2007; 46(7): 551-4. [In Chinese].