Department of Metabolic Diseases, Jagiellonian University Medical College, 15 Kopernika St., 31-501, Krakow, Poland.
University Hospital, 36 Kopernika St., 31-501, Krakow, Poland.
Sci Rep. 2018 May 2;8(1):6938. doi: 10.1038/s41598-018-25135-y.
Post-thrombotic syndrome (PTS) is a common complication of deep vein thrombosis (DVT). Little is known about the involvement of adipokines in the pathogenesis of DVT. We evaluated whether adipokines can predict PTS. In a prospective cohort study, 320 DVT patients aged 70 years or less were enrolled. Serum adiponectin, leptin and resistin levels were measured three months since the index first-ever DVT. After 2 years' follow-up PTS was diagnosed in 83 of 309 available patients (26.9%) who had 13.9% lower adiponectin and 16% higher leptin levels compared with the remainder (both p < 0.0001). No PTS-associated differences in C-reactive protein, fibrinogen, D-dimer, plasminogen activator inhibitor-1 and resistin were observed. The multivariable logistic regression adjusted for age, sex, obesity and tissue plasminogen activator (tPa) showed that lower adiponectin (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.31-0.56) and higher leptin levels (OR, 1.49; 95% CI, 1.31-1.69) are independent predictors for PTS. Obesity-stratified logistic regression analysis confirmed that lower adiponectin (OR, 0.49; 95% CI, 0.38-0.64) and higher leptin (OR, 1.41; 95% Cl, 1.25-1.58) levels predicted PTS. Our findings showed that lower adiponectin and higher leptin measured 3 months after DVT, regardless of obesity, can independently predict PTS, which suggests novel links between adipokines and thrombosis.
静脉血栓后综合征（PTS）是深静脉血栓（DVT）的常见并发症。关于脂联素在 DVT 发病机制中的作用知之甚少。我们评估了脂联素是否可以预测 PTS。在一项前瞻性队列研究中，纳入了 320 名年龄在 70 岁及以下的首次发生 DVT 的患者。在首次 DVT 后三个月测量血清脂联素、瘦素和抵抗素水平。在 2 年的随访中，309 名可随访的患者中有 83 名（26.9%）诊断为 PTS，与其余患者相比，这些患者的脂联素水平低 13.9%，瘦素水平高 16%（均 P<0.0001）。未观察到 PTS 相关的 C 反应蛋白、纤维蛋白原、D-二聚体、纤溶酶原激活物抑制剂-1 和抵抗素的差异。多变量逻辑回归调整年龄、性别、肥胖和组织型纤溶酶原激活物（tPA）后显示，较低的脂联素（比值比 [OR]，0.42；95%置信区间 [CI]，0.31-0.56）和较高的瘦素水平（OR，1.49；95%CI，1.31-1.69）是 PTS 的独立预测因素。肥胖分层的逻辑回归分析证实，较低的脂联素（OR，0.49；95%CI，0.38-0.64）和较高的瘦素（OR，1.41；95%Cl，1.25-1.58）水平预测 PTS。我们的研究结果表明，DVT 后 3 个月测量的脂联素水平较低和瘦素水平较高，无论肥胖与否，都可以独立预测 PTS，这表明脂联素和血栓之间存在新的联系。
