From the Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru.
Escuela de Medicina, Universidad Científica del Sur, Lima, Peru.
Cardiol Rev. 2024;32(2):97-103. doi: 10.1097/CRD.0000000000000470. Epub 2022 Sep 21.
This systematic review aimed to evaluate metabolic syndrome as a risk factor for the development of peripheral arterial disease (PAD). We searched in four databases: (1) PubMed, (2) Web of Science, (3) Scopus, and (4) Embase until March 2021. We included cohort studies that evaluated the risk of PAD in patients with and without metabolic syndrome. Study selection, data extraction, and risk of bias analysis were performed independently by 2 authors. We used a random-effects model to conduct a meta-analysis of effect measures [hazard ratio (HR), risk ratio (RR), and odds ratio (OR)]. Individual analyses were performed according to the diagnostic criterion used for metabolic syndrome. We included 7 cohort studies with a total of 43 824 participants. Most of the studies were performed in the general adult population. The metabolic syndrome and PAD diagnostic criteria used in the individual studies were heterogeneous. Almost all studies using RR found an association between metabolic syndrome and the development of PAD (RR: 1.31; confidence interval 95%: 1.03-1.59; I 2 : 15.6%). On the other hand, almost all the studies that used HR found no association between the two variables. All studies had a low risk of bias. In conclusion, available evidence on the association between metabolic syndrome and the risk of developing PAD is inconsistent. However, given the high prevalence of risk factors that patients with metabolic syndrome have, testing to rule out PAD could be recommended. Future studies should analyze each component of the metabolic syndrome separately and according to the severity of PAD.
本系统评价旨在评估代谢综合征作为外周动脉疾病（PAD）发展的风险因素。我们在四个数据库中进行了搜索：（1）PubMed，（2）Web of Science，（3）Scopus，（4）Embase，直到 2021 年 3 月。我们纳入了评估代谢综合征患者和无代谢综合征患者 PAD 风险的队列研究。两位作者独立进行了研究选择、数据提取和偏倚风险分析。我们使用随机效应模型对效应测量值[风险比（HR）、风险比（RR）和比值比（OR）]进行荟萃分析。根据代谢综合征的诊断标准进行了个体分析。我们纳入了 7 项队列研究，共 43824 名参与者。大多数研究都是在普通成年人群中进行的。个体研究中使用的代谢综合征和 PAD 诊断标准存在异质性。几乎所有使用 RR 的研究都发现代谢综合征与 PAD 的发生之间存在关联（RR：1.31；95%置信区间：1.03-1.59；I 2 ：15.6%）。另一方面，几乎所有使用 HR 的研究都没有发现这两个变量之间存在关联。所有研究的偏倚风险都较低。总之，目前关于代谢综合征与 PAD 发病风险之间关联的证据不一致。然而，鉴于代谢综合征患者具有较高的危险因素患病率，建议进行检测以排除 PAD。未来的研究应根据 PAD 的严重程度单独分析代谢综合征的每个组成部分。
