Department of Clinical Medicine, K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, 9037, Tromsø, Norway,
Eur J Epidemiol. 2014 Nov;29(11):821-30. doi: 10.1007/s10654-014-9950-z. Epub 2014 Sep 12.
Obesity is a risk factor for arterial and venous thromboembolism. However, it is not known whether obesity mediates risk through shared mechanisms. In a population-based cohort, we aimed to compare the impact of obesity measures on risk of venous thromboembolism (VTE) and myocardial infarction (MI), and explore how obesity-related atherosclerotic risk factors influenced these relationships. Measures of body composition including body mass index , waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR) and waist-to-height ratio (WHtR) were registered in 6,708 subjects aged 25-84 years, who participated in the Tromsø Study (1994-1995). Incident VTE- and MI-events were registered until January 1, 2011. There were 288 VTEs and 925 MIs during a median of 15.7 years of follow-up. All obesity measures were related to risk of VTE. In linear models, WC showed the highest risk estimates in both genders. In categorized models (highest versus lowest quintile), WC showed highest risk in men (HR 3.59; 95 % CI 1.82-7.06) and HC in women (HR 2.27; 95 % CI 1.54-4.92). Contrary, WHR and WHtR yielded the highest risk estimates for MI. The HR of MI (highest vs. lowest quintile) for WHR was 2.11 (95 % CI 1.59-2.81) in men and 1.62 (95 % CI 1.13-2.31) in women. The risk estimates for MI were substantially attenuated after adjustment for atherosclerotic risk factors, whereas the estimates for VTE remained unchanged. Our findings suggest that the impact of body fat distribution, and the causal pathway, differs for the association between obesity and arterial and venous thrombosis.
肥胖是动脉和静脉血栓栓塞的一个危险因素。然而，目前尚不清楚肥胖是否通过共同的机制来介导这种风险。在一项基于人群的队列研究中，我们旨在比较肥胖指标对静脉血栓栓塞（VTE）和心肌梗死（MI）风险的影响，并探讨与肥胖相关的动脉粥样硬化危险因素如何影响这些关系。在 6708 名年龄在 25-84 岁的参与者中，我们登记了身体成分的测量指标，包括体重指数（BMI）、腰围（WC）、臀围（HC）、腰臀比（WHR）和腰高比（WHtR），他们参加了特罗姆瑟研究（1994-1995 年）。直到 2011 年 1 月 1 日，我们登记了 VTE 和 MI 事件的发病情况。在中位随访 15.7 年期间，共发生了 288 例 VTE 和 925 例 MI。所有肥胖指标均与 VTE 风险相关。在线性模型中，WC 在男女两性中均显示出最高的风险估计值。在分类模型（最高五分位与最低五分位）中，WC 在男性中显示出最高的风险（HR 3.59；95 % CI 1.82-7.06），HC 在女性中显示出最高的风险（HR 2.27；95 % CI 1.54-4.92）。相反，WHR 和 WHtR 对 MI 的风险估计值最高。在男性中，WHR 最高五分位与最低五分位相比，MI 的 HR 为 2.11（95 % CI 1.59-2.81），在女性中为 1.62（95 % CI 1.13-2.31）。调整动脉粥样硬化危险因素后，MI 的风险估计值显著降低，而 VTE 的风险估计值则保持不变。我们的研究结果表明，体脂分布的影响以及肥胖与动脉和静脉血栓形成之间关联的因果途径在不同性别中存在差异。
