Underweight is associated with a reduced risk of venous thromboembolism. Results from the EDITH case-control study

Delluc, Aurélien; Mottier, Dominique; Gal, Grégoire Le; Oger, Emmanuel; Lacut, Karine

doi:10.1111/j.1538-7836.2009.03280.x

Cited by 27 publications

(17 citation statements)

References 9 publications

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“…We found a dramatic increase in the prevalence of obesity and severe obesity among both sexes of the Olmsted County population, 1988–2010, and obesity was significantly associated with the incidence of idiopathic VTE, accounting for about one-third of the increase in idiopathic VTE incidence (obesity PAR=0.33 for idiopathic VTE). These findings confirm and extend previous observations of a significant association of overweight and obese BMI with idiopathic VTE [34]. In contrast, the PAR due to above-normal BMI for secondary VTE was “−8%”, suggesting that forcing the population to return to normal BMI confers no benefit with respect to incident secondary VTE.…”

Section: Discussionsupporting

confidence: 89%

Reasons for the persistent incidence of venous thromboembolism

Heit¹,

Ashrani²,

Crusan³

et al. 2017

Thromb Haemost

101

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Background Reasons for trends in venous thromboembolism (VTE) incidence are uncertain. Objectives To determine VTE incidence trends and risk factor prevalence, and estimate population-attributable risk (PAR) trends for each risk factor. Patients/Methods In a population-based cohort study of all residents of Olmsted County, MN, 1981–2010, annual incidence rates were calculated using incident VTE cases as the numerator and age- and sex-specific Olmsted County population estimates as the denominator. Poisson regression models were used to assess the relationship of crude incidence rates to year of diagnosis, age at diagnosis, and sex. Trends in annual prevalence of major VTE risk factors prevalence were estimated using linear regression. Poisson regression with time-dependent risk factors (person-years approach) was used to model the entire population of Olmsted County and derive the PAR. Results The age- and sex-adjusted annual VTE incidence, 1981–2010, did not change significantly. Over the time period, 1988–2010, the prevalence of obesity, surgery, active cancer and leg paresis increased. Patient age, hospitalization, surgery, cancer, trauma, leg paresis and nursing home confinement jointly accounted for 79% of incident VTE; obesity accounted for 33% of incident idiopathic VTE. The increasing prevalence of obesity, cancer and surgery accounted in part for the persistent VTE incidence. The PAR of active cancer and surgery, 1981–2010, signficiantly increased. Conclusions Almost 80% of incident VTE events are attributable to known major VTE risk factors and one-third of incident idiopathic VTE events are attributable to obesity. Increasing surgery PAR suggests that concurrent efforts to prevent VTE may have been insufficient.

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Section: Discussionsupporting

confidence: 89%

Reasons for the persistent incidence of venous thromboembolism

Heit¹,

Ashrani²,

Crusan³

et al. 2017

Thromb Haemost

101

View full text Add to dashboard Cite

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“…Incidence of thrombosis, however, was not affected in this population after 2006 national regulations on these agents emerged in view of recognized adverse outcomes. Underweight BMI (<18.5 kg/m 2 ) is described as protective for the development of venous thrombosis, 28 and our data are concordant with this view. The lack of association in our cohort between obesity and thrombosis timing supports the obesity paradox, a theory described mostly in the cardiovascular literature, 29 that although obese individuals are clearly at increased risk for the development of comorbidities, they are relatively protected against morbidity (such as thrombosis) and mortality associated with these established disease states.…”

Section: Discussionsupporting

confidence: 90%

Analysis of incidence and clinical outcomes in patients with thromboembolic events and invasive exocrine pancreatic cancer

Epstein

Soff

Capanu

et al. 2011

Cancer

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TEs are common in exocrine pancreatic cancer, with coagulopathy, erythropoietin-stimulating agent use, and underweight BMI influencing thrombosis timing. TEs, particularly early ones, confer a significantly worse prognosis, suggesting a biological significance, underscoring the relevance of ongoing prophylaxis trials, and raising the question of whether early TEs should be considered a stratification factor for clinical trials.

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“…Fatty tissue also had a proinflammatory, prothrombotic, and hypofibrinolytic role. The risk of DVT has been found to be directly proportional to body weight with an overall reduced risk of underweight subjects and a significantly higher risk in the obese subjects . Furthermore, the Atherosclerosis Risk in Communities (ARIC) and the Cardiovascular Health Study (CHS) also demonstrated an increased risk of VTE formation with obesity with a hazard ratio of 2.7 for a BMI > 40 .…”

Section: Discussionmentioning

confidence: 99%