Metabolic Syndrome Impairs Function, Health-Related Quality of Life, and Peripheral Circulation in Patients with Intermittent Claudication

Abstract

Patients limited by intermittent claudication have multiple co-morbid conditions and are sendentary, thereby increasing their risk of having metabolic syndrome. Metabolic syndrome's possible negative effects on ambulation and peripheral circulation in these patients are of particular importance. PURPOSE: To examine the effect of metabolic syndrome on intermittent claudication and peripheral circulation in patients with peripheral arterial disease (PAD), and to determine whether peripheral vascular function was predictive of the severity of intermittent claudication in patients with metabolic syndrome. METHODS: Patients limited by intermittent claudication who had metabolic syndrome (n = 155) were compared to those without metabolic syndrome (n = 428). Patients were assessed on metabolic syndrome characteristics, ambulatory function, and peripheral vascular function. RESULTS: Initial claudication distance (ICD) was 30% shorter (p = 0.007) in patients with metabolic syndrome than in the controls (133 ± 119 vs. 189 ± 165 m; mean ± SD), and absolute claudication distance (ACD) was 21% shorter (p = 0.028) (327 ± 194 vs. 413 ± 248 m). Furthermore, patients with metabolic syndrome had greater calf ischemia (p = 0.016) following a vascular occlusion test. Calf ischemia was correlated with ICD (r = 0.28, p = 0.031), and ACD (r = 0.39, p = 0.003) in the group with metabolic syndrome. CONCLUSION: Metabolic syndrome worsens intermittent claudication and peripheral circulation in patients with PAD. Thus, the additive burden of metabolic syndrome places patients limited by intermittent claudication at even greater risk for living a functionally dependent lifestyle. Supported by NIH (R01-AG-16685, K01-00657).