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联合生活方式和多基因风险与静脉血栓栓塞症发生率的关联:一项大型基于人群的队列研究。

Association of Combined Lifestyle and Polygenetic Risk with Incidence of Venous Thromboembolism: A Large Population-Based Cohort Study.

机构信息

Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.

Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.

出版信息

Thromb Haemost. 2022 Sep;122(9):1549-1557. doi: 10.1055/s-0042-1744377. Epub 2022 May 27.

DOI:10.1055/s-0042-1744377
PMID:35623617
Abstract

As one of the fatal complications, venous thromboembolism (VTE) is associated with increased mortality. However, the combined effects of adopting multiple healthy lifestyles have not been firmly demonstrated. This study was to evaluate the association of combined healthy lifestyles and genetic risk factors with VTE and to investigate their interaction. A prospective cohort study from UK Biobank with a total of 442,963 men and women aged between 38 to 73 years were recruited from 2006 to 2010 and followed up through 2017 or 2018. A polygenic risk score was constructed and a weighted healthy lifestyle score, including no current smoking, regular physical exercises, healthy diet, and healthy body mass index, was categorized. During a median follow-up 9.0 years (3,912,396 person-years), there were 6,736 (172 per 100,000 person-years) incident VTE cases recorded. Among the participants with an unfavorable lifestyle, 1.80% developed VTE, versus 1.03% of the participants with a favorable lifestyle (hazard ratio [HR]: 1.58; 95% confidence interval [CI]: 1.48-1.68). Of the participants with high genetic risk, 2.42% developed VTE, versus 0.97% of the participants with low genetic risk (HR: 2.60; 95% CI: 2.39-2.81). Moreover, of the participants with high genetic risk and unfavorable lifestyle, 2.90% developed VTE, versus 0.66% of the participants with low genetic risk and favorable lifestyle (HR: 4.09; 95% CI: 3.48-4.79). No significant interaction between genetic risk and lifestyle factors was observed ( for interaction = 0.727). An unfavorable lifestyle was associated with a substantially higher risk of VTE, regardless of the genetic risk strata.

摘要

静脉血栓栓塞症 (VTE) 是一种致命的并发症,与死亡率的增加有关。然而,采用多种健康生活方式的综合效果尚未得到明确证实。本研究旨在评估综合健康生活方式和遗传风险因素与 VTE 的关联,并探讨它们之间的相互作用。这项前瞻性队列研究来自英国生物库,共有 442963 名年龄在 38 至 73 岁之间的男性和女性于 2006 年至 2010 年招募,并随访至 2017 年或 2018 年。构建了多基因风险评分,并构建了加权健康生活方式评分,包括不吸烟、定期体育锻炼、健康饮食和健康体重指数。在中位随访 9.0 年(3912396 人年)期间,记录了 6736 例(每 100000 人年 172 例)新发 VTE 病例。在生活方式不利的参与者中,有 1.80%发生了 VTE,而生活方式有利的参与者中只有 1.03%(风险比 [HR]:1.58;95%置信区间 [CI]:1.48-1.68)。在遗传风险较高的参与者中,有 2.42%发生了 VTE,而遗传风险较低的参与者中只有 0.97%(HR:2.60;95%CI:2.39-2.81)。此外,在遗传风险高且生活方式不利的参与者中,有 2.90%发生了 VTE,而遗传风险低且生活方式有利的参与者中只有 0.66%(HR:4.09;95%CI:3.48-4.79)。未观察到遗传风险和生活方式因素之间存在显著交互作用( for interaction = 0.727)。无论遗传风险分层如何,不利的生活方式都与 VTE 的风险显著增加有关。

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