Stokes Sean, Breheny Patrick, Radulescu Aurelia, Radulescu Vlad Calin
Department of Pediatrics, University of Kentucky, Lexington, USA.
Pediatr Hematol Oncol. 2014 Aug;31(5):475-80. doi: 10.3109/08880018.2014.886315. Epub 2014 Mar 31.
The incidence of venous thromboembolism in children has increased significantly over the past 20 years. Over the same period of time, there was an increase in the prevalence of obesity in the pediatric population. Obesity is a known risk factor for VTE in adults, but little information is available in children.
This study evaluates the relation between obesity and VTE using a retrospective, case-control design, comparing the body mass index (BMI) of patients admitted with a diagnosis of VTE versus patients admitted with other diagnoses, at a single institution, between 2007 and 2011.
We studied 48 inpatients diagnosed with deep venous thrombosis or pulmonary embolism and a control group of 274 age and gender matched patients admitted with other diagnoses. We found obese patients (BMI > 95th percentile) to have significantly higher risk of VTE (odds ratio 2.1, with 95% CI 1.1-4.2) than patients of normal weight (BMI < 85th percentile). Overweight patients (BMI 85th-95th percentile) did not demonstrate a significant change in risk. Most of the VTE patients were adolescents and the majority of them had other identifiable risk factors for thrombosis.
This study establishes a correlation between obesity and VTE in a group of hospitalized children, showing a risk for VTE in obese children similar to the one described in much larger adult cohorts.
在过去20年中,儿童静脉血栓栓塞症的发病率显著上升。在同一时期,儿科人群中的肥胖患病率也有所增加。肥胖是成人静脉血栓栓塞症的已知危险因素,但关于儿童的相关信息却很少。
本研究采用回顾性病例对照设计,评估肥胖与静脉血栓栓塞症之间的关系,比较了2007年至2011年期间在单一机构中因静脉血栓栓塞症诊断入院的患者与因其他诊断入院的患者的体重指数(BMI)。
我们研究了48例被诊断为深静脉血栓形成或肺栓塞的住院患者以及274例年龄和性别匹配、因其他诊断入院的对照组患者。我们发现肥胖患者(BMI>第95百分位数)发生静脉血栓栓塞症的风险(优势比2.1,95%置信区间1.1 - 4.2)显著高于正常体重患者(BMI<第85百分位数)。超重患者(BMI第85 - 95百分位数)的风险未显示出显著变化。大多数静脉血栓栓塞症患者为青少年,且他们中的大多数有其他可识别的血栓形成危险因素。
本研究在一组住院儿童中建立了肥胖与静脉血栓栓塞症之间的相关性,表明肥胖儿童发生静脉血栓栓塞症的风险与在规模大得多的成人队列中所描述的风险相似。