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[Ankle-brachial index testing is particularly indicated in patients with metabolic syndrome but without known arterial disease].

INTRODUCTION
The objective was to investigate the prevalence of metabolic syndrome (MetS), its cardiovascular disease (CVD) risk and its association with peripheral arterial disease, defined by a low ankle-brachial index (ABI) (< 0.90), in primary prevention.


MATERIAL AND METHODS
Cross-sectional study performed in the primary care general population, aged 50-79 years. CVD risk and ABI were measured in persons without known arterial disease with MetS and in a control group. MetS was defined by Adult Treatment Panel III. CVD risk was estimated using the Systematic Coronary Risk Evaluation (SCORE).


RESULTS
A total of 581 subjects were recruited. The prevalence of the metabolic syndrome was 30.8% (95% confidence interval [CI], 27.0-34.5). For the CVD risk and ABI studies 217 individuals were included (138 with MetS and 49 with diabetes). Average CVD risk was high (5%) on patients with MetS and twice as much as those without MetS. ABI was low (< 0.90) on 15 subjects [6.9% (95% CI), 3.5-10.2], with higher frequency in the MetS group: 14 patients (10.1%) vs 1 patient (1.3%). The frequency of low ABI in patients with and without diabetes was 18.3% and 3.6% respectively. Low ABI was associated to MetS, diabetes, inactivity, high risk of SCORE and less alcohol habit. In the multivariate analysis, the odds ratio for the association MetS/low ABI was 14.7 (95% CI, 1.7-123.6).


CONCLUSION
MetS is related to asymptomatic peripheral arterial disease. Thus, the measure of ABI in those patients with this syndrome is recommended.