Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
Br J Haematol. 2010 Apr;149(2):273-9. doi: 10.1111/j.1365-2141.2010.08086.x. Epub 2010 Feb 8.
The F5 G1691A (Factor V Leiden) and F2 G20210A (prothrombin) mutations are linked to an increase in the incidence rate of venous thromboembolism (VTE), but their effects are highly variable. We investigated whether the effects of smoking and obesity might explain this variability. In a case-cohort study including the participants of the Danish Diet, Cancer and Health study, we computed incidence rates and Cox proportional hazard ratios for VTE in individuals with and without the mutations, categorized by weight and tobacco consumption. The sole effect of heavy smoking was 128 extra VTE events per 100,000 person years in individuals with the F5 G1691A mutation versus 59 in individuals without. The sole effect of obesity was 222 extra VTE events per 100,000 person years in individuals with the F5 G1691A mutation, versus 103 in individuals without this mutation; and 705 extra VTE events per 100,000 person years in individuals with the F2 G20210A mutation versus 107 in individuals without this mutation. The F5 G1691A and F2 G20210A mutations conferred increased susceptibility to the unfavourable effects of smoking and obesity on the risk for VTE. Thus, individuals with genetic risk factors for VTE might benefit from maintaining a healthy lifestyle.
F5 G1691A（因子 V 莱顿）和 F2 G20210A（凝血酶原）突变与静脉血栓栓塞症（VTE）发生率的增加有关，但它们的影响具有高度的可变性。我们研究了吸烟和肥胖是否可以解释这种可变性。在一项包括丹麦饮食、癌症和健康研究参与者的病例对照研究中，我们根据体重和吸烟量对携带和不携带突变的个体进行了 VTE 发生率和 Cox 比例风险比的计算。在携带 F5 G1691A 突变的个体中，重度吸烟的单一影响是每 10 万人年增加 128 例 VTE 事件，而不携带突变的个体则为 59 例。在携带 F5 G1691A 突变的个体中，肥胖的单一影响是每 10 万人年增加 222 例 VTE 事件，而不携带突变的个体则为 103 例；携带 F2 G20210A 突变的个体每 10 万人年增加 705 例 VTE 事件，而不携带突变的个体则为 107 例。F5 G1691A 和 F2 G20210A 突变增加了对吸烟和肥胖对 VTE 风险不利影响的易感性。因此，具有 VTE 遗传风险因素的个体可能受益于保持健康的生活方式。
