Insulin resistance is significantly associated with the metabolic syndrome, but not with sonographically proven peripheral arterial disease

Objective: Insulin resistance (IR) is the key feature of the metabolic syndrome (MetS); its association with peripheral arterial disease (PAD) is unclear. We hypothesized that IR is associated with both the MetS and sonographically proven PAD. Methods: IR was determined by the Homeostasis Model Assessment (HOMA) index in 214 patients with sonographically proven PAD as well as in 197 controls, who did not have a history of PAD and in whom coronary artery disease was ruled out angiographically; the MetS was defined according to NCEP-ATPIII criteria. Results: HOMA IR scores were significantly higher in MetS patients than in subjects without the MetS (5.9 +/- 6.2 vs. 2.9 +/- 3.9; p <0.001). However, HOMA IR did not differ significantly between patients with PAD and controls (4.2 +/- 5.4 vs. 3.3 +/- 4.3; p = 0.124). When both, the presence of MetS and of PAD were considered, HOMA IR was significantly higher in patients with the MetS both among those with PAD (6.1 +/- 5.7 vs. 3.6 +/- 5.2; p<0.001) and among controls (5.8 +/- 6.8 vs. 2.3 +/- 1.8; p <0.001), whereas it did not differ significantly between patients with PAD and controls among patients with the MetS (5.8 +/- 6.8 vs. 6.1 +/- 5.7; p = 0.587) nor among those without the MetS (2.3 +/- 1.8 vs. 3.6 +/- 5.2; p = 0.165). Similar results were obtained with the International Diabetes Federation definition of the MetS. Conclusion: IR is significantly associated with the MetS but not with sonographically proven PAD.