Weight Change and Risk of Venous Thromboembolism: The Tromsø Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Dec 21

PMID 27997594

Citations 11

Authors

Lars Daae Horvei

Sigrid K Braekkan

John-Bjarne Hansen

Affiliations

Soon will be listed here.

Abstract

Background: Obesity is a major risk factor for venous thromboembolism (VTE), but it is unknown to what extent weight change over time affects VTE risk.

Aims: To investigate the association between weight change and risk of incident VTE in a population-based cohort with repeated measurements.

Methods: Participant data were collected from the Tromsø 3 (1986-87), 4 (1994-95), 5 (2000-01) and 6 (2007-08) surveys. Subjects who attended two subsequent or more surveys were included (n = 17802), and weight change between the surveys was calculated. Person-time at risk was accrued from the second of two subsequent vists until the next survey, the date of an incident VTE, migration, death or study end (December 31st 2012), whichever came first. Cox regression models were used to calculate risk of VTE according to change in body weight.

Results: There were 302 incident VTE events during a median of 6.0 years of follow-up. Subjects who gained most weight (7.5-40.0 kg weight gain) had a 1.9-fold higher risk of VTE compared to those with no or a moderate (0-7.4 kg) weight gain (HR 1.92; 95% CI 1.38-2.68). The VTE risk by ≥7.5 kgs over no or moderate (0-7.4 kg) weight gain was highest (HR 3.75; 95% 1.83-7.68) in subjects with baseline body mass index (BMI) ≥30 kg/m2. There was a joint effect of weight gain and baseline BMI on VTE risk. Those with BMI ≥30 who gained ≥7.5 kgs had a 6.6-fold increased risk (HR 6.64; 95% CI 3.61-12.22) compared to subjects with BMI <25 and no or moderate (0-7.4 kg) weight gain.

Conclusions: Our findings imply that further weight gain is a considerable risk factor for VTE, particularly in obese individuals.

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References

Faber D, de Groot P, Visseren F . Role of adipose tissue in haemostasis, coagulation and fibrinolysis. Obes Rev. 2009; 10(5):554-63. DOI: 10.1111/j.1467-789X.2009.00593.x. View

Wattanakit K, Lutsey P, Bell E, Gornik H, Cushman M, Heckbert S . Association between cardiovascular disease risk factors and occurrence of venous thromboembolism. A time-dependent analysis. Thromb Haemost. 2012; 108(3):508-15. PMC: 3482827. DOI: 10.1160/TH11-10-0726. View

Rosendaal F . Venous thrombosis: a multicausal disease. Lancet. 1999; 353(9159):1167-73. DOI: 10.1016/s0140-6736(98)10266-0. View

Bertina R . The role of procoagulants and anticoagulants in the development of venous thromboembolism. Thromb Res. 2009; 123 Suppl 4:S41-5. DOI: 10.1016/S0049-3848(09)70142-2. View

Kimura Y, Pham N, Yasuda K, Nanri A, Kurotani K, Kuwahara K . Association of adulthood weight gain with circulating adipokine and insulin resistance in the Japanese population. Eur J Clin Nutr. 2014; 69(4):462-6. DOI: 10.1038/ejcn.2014.257. View

Braekkan S, Siegerink B, Lijfering W, Hansen J, Cannegieter S, Rosendaal F . Role of obesity in the etiology of deep vein thrombosis and pulmonary embolism: current epidemiological insights. Semin Thromb Hemost. 2013; 39(5):533-40. DOI: 10.1055/s-0033-1343355. View

Harrington M, Gibson S, Cottrell R . A review and meta-analysis of the effect of weight loss on all-cause mortality risk. Nutr Res Rev. 2009; 22(1):93-108. DOI: 10.1017/S0954422409990035. View

Willenberg T, Schumacher A, Amann-Vesti B, Jacomella V, Thalhammer C, Diehm N . Impact of obesity on venous hemodynamics of the lower limbs. J Vasc Surg. 2010; 52(3):664-8. DOI: 10.1016/j.jvs.2010.04.023. View

Mehta T, Smith Jr D, Muhammad J, Casazza K . Impact of weight cycling on risk of morbidity and mortality. Obes Rev. 2014; 15(11):870-81. PMC: 4205264. DOI: 10.1111/obr.12222. View

10.

French S, Jeffery R, Folsom A, Williamson D, Byers T . Relation of weight variability and intentionality of weight loss to disease history and health-related variables in a population-based sample of women aged 55-69 years. Am J Epidemiol. 1995; 142(12):1306-14. DOI: 10.1093/oxfordjournals.aje.a117598. View

11.

Colditz G, Willett W, Rotnitzky A, Manson J . Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. 1995; 122(7):481-6. DOI: 10.7326/0003-4819-122-7-199504010-00001. View

12.

Timp J, Braekkan S, Versteeg H, Cannegieter S . Epidemiology of cancer-associated venous thrombosis. Blood. 2013; 122(10):1712-23. DOI: 10.1182/blood-2013-04-460121. View

13.

Chen Y, Zhang L, Wang G, Zeng H, Lu B, Shen X . Adiponectin inhibits tissue factor expression and enhances tissue factor pathway inhibitor expression in human endothelial cells. Thromb Haemost. 2008; 100(2):291-300. View

14.

Furie B, Furie B . Mechanisms of thrombus formation. N Engl J Med. 2008; 359(9):938-49. DOI: 10.1056/NEJMra0801082. View

15.

Borch K, Braekkan S, Mathiesen E, Njolstad I, Wilsgaard T, Stormer J . Anthropometric measures of obesity and risk of venous thromboembolism: the Tromso study. Arterioscler Thromb Vasc Biol. 2009; 30(1):121-7. DOI: 10.1161/ATVBAHA.109.188920. View

16.

Severinsen M, Kristensen S, Johnsen S, Dethlefsen C, Tjonneland A, Overvad K . Anthropometry, body fat, and venous thromboembolism: a Danish follow-up study. Circulation. 2009; 120(19):1850-7. DOI: 10.1161/CIRCULATIONAHA.109.863241. View

17.

Steffen L, Cushman M, Peacock J, Heckbert S, Jacobs Jr D, Rosamond W . Metabolic syndrome and risk of venous thromboembolism: Longitudinal Investigation of Thromboembolism Etiology. J Thromb Haemost. 2009; 7(5):746-51. PMC: 2810102. DOI: 10.1111/j.1538-7836.2009.03295.x. View

18.

Meltzer M, Lisman T, de Groot P, Meijers J, le Cessie S, Doggen C . Venous thrombosis risk associated with plasma hypofibrinolysis is explained by elevated plasma levels of TAFI and PAI-1. Blood. 2010; 116(1):113-21. DOI: 10.1182/blood-2010-02-267740. View

19.

Larsen I, Smastuen M, Johannesen T, Langmark F, Parkin D, Bray F . Data quality at the Cancer Registry of Norway: an overview of comparability, completeness, validity and timeliness. Eur J Cancer. 2008; 45(7):1218-1231. DOI: 10.1016/j.ejca.2008.10.037. View

20.

De Pergola G, Pannacciulli N . Coagulation and fibrinolysis abnormalities in obesity. J Endocrinol Invest. 2003; 25(10):899-904. DOI: 10.1007/BF03344054. View