Background: patients with metabolic syndrome have increased vascular events risk. New imaging techniques are necessary for the early assessment and management of these patients.

Aim of study: compare aortic stiffness index (β) and as an indicator of arterial stiffness, to brachial arterial flow-mediated vasodilation (FMD) and common carotid artery intima-media thickness (IMT), because they are standard indicators of endothelial dysfunction and atherosclerosis.

Methods: patients with metabolic syndrome signs (ATP criteria III, 2005) were included, as well as 48 healthy individuals were investigated. Arterial stiffness was assessed by echocardiography. Brachial arterial FMD and IMT were determined using high-resolution ultrasonography. All metabolic patients exerted impaired FMD (3.9 0.8%), increased IMT (0.86 +0.12 mm), β (7.8 +1.2) in comparison to control subjects (FMD = 8.4 + 1.1%; IMT = 0.69 + 0.1 mm; β (3.2 +1.0) (p < 0.05). The significant negative correlation of FMD with β (R = −0.69; p < 0.001) was found. There was significant positive correlation between IMT and β (R = 0.48; p = 0.004). β, IMT positively correlated and FMD negatively correlated with the age of the metabolic patients. Arterial stiffness indicated by increased β index is associated with endothelial dysfunction and overt atherosclerosis in patients with metabolic syndrome. Assessment of arterial stiffness, FMD, and IMT are reproducible and reliable noninvasive techniques for the complex assessment of vascular abnormalities in metabolic patients. This date suggest, that this techniques may be used as a predictors of cardiovascular risk events.