Yasemin Kaldırım ARMUTCUOĞLU, Tuğba Tolu BÜLTE, Refik DEMİRTUNÇ
Haydarpaşa Numune Medical Journal - 2026;66(3):259-264
Introduction: Xanthelasma palpebrarum (XP) has been increasingly recognized as a potential cutaneous marker of systemic metabolic and vascular disorders. The ankle-brachial index (ABI) is a simple, non-invasive tool for detecting subclinical atherosclerotic burden. This study aimed to investigate the association between xanthelasma and ABI. Methods: In this single-center, descriptive cross-sectional study, 121 participants were evaluated. Patients with clinically diagnosed xanthelasma formed the study group, while age- and sex-matched individuals without xanthelasma served as controls. Demographics, cardiovascular risk factors, body mass index (BMI), and laboratory parameters were recorded. ABI was measured using a handheld Doppler device, with values <=0.90 indicating peripheral artery disease and >=1.30 suggesting medial arterial calcification. Results: Patients with xanthelasma had significantly higher BMI (31.8+/-6.4 vs. 28.7+/-4.1 kg/m²; p=0.002), low-density lipoprotein (LDL) cholesterol (144.7+/-50.2 vs. 129.2+/-37.1 mg/dL; p=0.046), Homeostasis Model Assessment of İnsulin Resistance (4.54+/-5.22 vs. 2.90+/-2.66; p=0.025), and free thyroxine levels (p=0.001), whereas serum 25-hydroxy Vitamin D was lower (p=0.014). ABI values were higher in the xanthelasma group (1.41+/-0.21 vs. 1.28+/-0.18; p<0.001). The prevalence of ABI >=1.30 was significantly greater (65.6% vs. 45.0%; p=0.023). Logistic regression revealed that xanthelasma increased the risk of medial arterial calcification by 2.3-fold (odds ratio: 2.33; 95% confidence interval: 1.12-4.85). Discussion and Conclusion: XP is associated with obesity, insulin resistance, elevated LDL cholesterol, and increased prevalence of ABI >=1.30, consistent with medial arterial calcification. These findings suggest that xanthelasma may serve as a non-invasive cutaneous marker of metabolic derangements and subclinical atherosclerotic burden. ABI measurement could represent a valuable adjunct in the evaluation of patients with xanthelasma. Larger multicenter prospective studies are required to validate these associations.
