Bureau Christophe, Laurent Julie, Robic Marie Angèle, Christol Camille, Guillaume Maeva, Ruidavets Jean Bernard, Ferrieres Jean, Péron Jean Marie, Vinel Jean Pierre
Service d'hépato-gastro-entérologie CHU Toulouse Hôpital Purpan et Université Paul Sabatier, Toulouse, France.
Service d'hépato-gastro-entérologie CHU Toulouse Hôpital Purpan et Université Paul Sabatier, Toulouse, France.
J Hepatol. 2016 Feb;64(2):427-432. doi: 10.1016/j.jhep.2015.08.024. Epub 2015 Aug 31.
BACKGROUND & AIMS: 30-40% of portal vein thrombosis (PVT) remains of unknown origin. An association between metabolic syndrome (MetS) and peripheral vein thrombosis has been reported but not with PVT, to date. The aim of this study was to investigate the association between MetS and PVT.
Between 2003 and 2014, all consecutive patients with non-cirrhotic PVT were prospectively included. Patient's characteristics and risks factors were recorded at the time of inclusion. Controls were selected by random in the general population and were matched 1/1 according to age and sex.
Seventy-nine patients with PVT were included: 40 present with at least one risk factor for PVT (SPVT) and 39 were found to be idiopathic (IPVT). The prevalence of MetS was 25.6% in SPVT group vs. 47.4% in IPVT group and 17.9% in controls from the general population (C-IPVT: p=0.01). The waist circumference and body mass index were higher in the IPVT group than in the SPVT group (105 vs. 93cm, p=0.004 and 29.4 vs. 25.0kg/m(2), p=0.004) and in the C-IPVT group (105 vs. 92cm, p=0.001 and 29.4 vs. 25.8kg/m(2), p=0.003). Overweight was observed in 82.0% of patients in the IPVT group vs. 44% in the SPVT group (p=0.002) and 51% in the C-IPVT group (p=0.01). The mean visceral fat area was higher in IPVT than in SPVT (18,223mm(2)vs. 12,690mm(2), p=0.02). In multivariate analyses, an increase in waist circumference was the strongest parameter associated with idiopathic PVT.
Central obesity is associated with PVT and could become one of the main risk factors for digestive thromboses.
30%-40%的门静脉血栓形成（PVT）病因不明。代谢综合征（MetS）与外周静脉血栓形成之间的关联已有报道，但迄今为止，与PVT的关联尚未见报道。本研究旨在探讨MetS与PVT之间的关联。
在2003年至2014年期间，前瞻性纳入所有连续性非肝硬化性PVT患者。在纳入时记录患者的特征和危险因素。在一般人群中随机选择对照，并根据年龄和性别进行1/1匹配。
纳入79例PVT患者：40例存在至少一种PVT危险因素（SPVT），39例为特发性（IPVT）。SPVT组MetS患病率为25.6%，IPVT组为47.4%，一般人群对照组（C-IPVT）为17.9%（p=0.01）。IPVT组的腰围和体重指数高于SPVT组（分别为105 vs. 93cm，p=0.004；29.4 vs. 25.0kg/m²，p=0.004）以及C-IPVT组（分别为105 vs. 92cm，p=0.001；29.4 vs. 25.8kg/m²，p=0.003）。IPVT组82.0%的患者超重，而SPVT组为44%（p=0.002），C-IPVT组为51%（p=0.01）。IPVT组的平均内脏脂肪面积高于SPVT组（18223mm²对12690mm²，p=0.02）。在多变量分析中，腰围增加是与特发性PVT相关的最强参数。
中心性肥胖与PVT相关，可能成为消化性血栓形成的主要危险因素之一。
