Chlamydia pneumoniae may trigger atherogenesis. Chlamydia trachomatis (CT) can also induce endothelial activation. However, its role in metabolic syndrome (METS), a proatherogenic entity, has remained unexplored. In this study the frequencies of IgA and IgG anti-CT antibodies were evaluated by immunoenzymatic assay in METS patients and healthy controls. The survey included 238 individuals (148 with METS). The mean age was 59.7 years. IgA anti-CT antibodies were found significantly more frequently in METS patients (16.9%) than in controls (5.6%) (P = 0.015). The role of such IgA response in METS should be further investigated.Key words cardiovascular disease, Chlamydia trachomatis, metabolic syndrome.Metabolic syndrome is a proinflammatory and prothrombotic state which leads to cardiovascular disease. METS is notable for generating a chronic inflammatory response (1, 2). Chlamydia are obligatory intracellular pathogens with a biphasic life cycle. In extracellular sites, their elementary bodies activate macrophages and lymphocytes, with consequent release of tumor necrosis factor and gamma-interferon (3).Infection with Chlamydia pneumoniae can be considered a contributor to atherogenesis, but it is not an independent risk factor for atherosclerotic disease (4, 5). CT, our focus in this study, is predominantly sexually transmitted, and causes eye and urogenital infections (6). Of interest, C. pneumoniae and the CT subtypes H and L infect human endothelial cells and induce a procoagulant state (7).Exposure to CT in patients with atherosclerotic disease has rarely been evaluated (8). The relationship of CT with METS has not so far been addressed. We herein evaluate This cross-sectional study includes individuals with METS who were followed at our Cardiometabolic Risk Outpatient Clinic. Three groups of individuals were evaluated: patients with METS without cardiac events (noncomplicated METS); patients with METS and previous cardiac events (acute myocardial infarction, acute coronary syndrome, myocardial revascularization surgery); and healthy controls. METS was diagnosed according to the classical criteria of the NCEP (9). Healthy controls paired by sex and age were selected from blood donors. Informed consent was obtained from all individuals who entered the study. The study was approved by the local ethics committee.IgA and IgG specific antibodies to the outer CT membrane protein were evaluated by immunoenzymatic assay, IgA antibodies with sensitivity 95% and specificity 98% and IgG antibodies with sensitivity 96% and specificity