Likelihood is greater among those metabolic syndrome.


GRAPEVINE, Tex.—Patients with the metabolic syndrome and decreased estimated glomerular filtration rate (eGFR) are at increased risk of having peripheral arterial disease (PAD), a study shows.

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The finding comes from an analysis of 2001-2004 data from two National Health and Nutrition Examination Surveys (NHANES) by researchers James F. Reed III, PhD, and Nelson P. Kopyt, DO, of Lehigh Valley Hospital in Allentown, Pa. The surveys gathered data from a national sample of U.S. adults.


In adults with and without the metabolic syndrome, the likelihood of PAD increased as eGFR decreased, but it increased at a greater rate in those with the syndrome, the investigators reported here at the National Kidney Foundation’s 2008 Spring Clinical Meetings.


Compared with subjects without metabolic syndrome and an eGFR of 90 mL/min per 1.73 m2 or higher, those who had the syndrome and an eGFR of 60-89, 30-59, and 15-29 mL/min per 1.73 m2 had a 3.55, 6.98, and 22.7 times higher risk of PAD, respectively.


The researchers calculated eGFR using the abbreviated Modfiication of Diet in Renal Disease Study formula based on serum creatinine, age, and race. They defined PAD as an ankle-brachial index (ADI) less than 0.9.  The researchers noted that PAD is a marker of subclinical coronary artery disease.


In a separate analysis of data from the two NHANES studies, Drs. Reed and Kopyt found that, overall, the prevalence of the metabolic syndrome increased with decreased eGFR. The prevalence among women is twice that of men.