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According to a study published in the June 2006 issue of the Journal of Vascular Surgery, metabolic syndrome worsens physical function, heath-related quality of life and peripheral circulation in patients with peripheral artery disease (PAD) and intermittent claudication (IC). According to researchers this is the first investigation examining the effect of metabolic syndrome on ambulation in PAD patients limited by IC. More future intervention trials are needed to extend our preliminary findings on how metabolic syndrome negatively impacts ambulation in functionally limited PAD patients.

Patients who have metabolic syndrome meet three or more of the following criteria:  abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, high blood pressure (more than 130/85 mm Hg) or fasting glucose of more than 110 mg/dL.    

Andrew Gardner, PhD, from University of Oklahoma Health Sciences Center served as lead author of the study.  He said 133 patients with IC and metabolic syndrome were compared to 201 patients without metabolic syndrome. 

“The percentage of people in this study who had metabolic syndrome was higher than the 23.7 percent prevalence in the adult population, but similar to the prevalence in those 60 years and older,” added Dr. Gardner.  “They were assessed on metabolic syndrome characteristics and PAD-specific measures.”
 
He said IC afflicts five percent of people over 55 in the United States and is a leading cause of morbidity in PAD.  “Patients with IC already have ambulatory dysfunction, are at the low end of the physical activity spectrum, and are limited in their daily physical activities," noted Dr. Gardner. "Compared to IC patients without metabolic syndrome, our study found that patients with metabolic syndrome had even shorter walking distances to onset and maximal claudication pain during a treadmill test; lower cardiovascular fitness; shorter six-minute walking distance; lower circulation in the legs; and lower quality of life pertaining to both physical and mental health.”

The study also found that there was a more rapid rate of claudication pain during the less intensive six minute walk test, and patients perceived that they had less ability to ambulate at varying distances and speeds and to climb stairs.

Dr. Gardner explained that earlier and more rapid development of leg symptoms associated with metabolic syndrome lead to impaired cardiopulmonary measures affecting cardiorespiratory fitness, and to less efficient walking which makes doing everyday tasks more difficult.

“Metabolic syndrome puts patients who already are limited by IC at greater risk for living a functionally dependent lifestyle,” added Dr. Gardner. “We believe aggressive risk factor modification for treating components of metabolic syndrome should be evaluated for efficacy in modifying physical and vascular function in patients with IC."

Dr. Gardner also noted that it is equally plausible that patients with metabolic syndrome can develop PAD and IC, as well as an elevated risk of subsequent cardiovascular morbidity and mortality.