Thrombosis Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Division of Internal Medicine, Thrombosis Research Center, University Hospital of North Norway, Tromsø, Norway.
Thromb Haemost. 2024 Mar;124(3):239-249. doi: 10.1055/s-0043-1772212. Epub 2023 Aug 7.
Obesity is a well-established risk factor for venous thromboembolism (VTE). However, data on the proportion of incident VTEs attributed to overweight and obesity in the general population are limited.
To investigate the population attributable fraction (PAF) of VTE due to overweight and obesity in a population-based cohort with repeated measurements of body mass index (BMI).
Participants from the fourth to seventh surveys of the Tromsø Study (enrolment: 1994-2016) were followed through 2020, and all incident VTEs were recorded. In total, 36,341 unique participants were included, and BMI measurements were updated for those attending more than one survey. BMI was categorized as <25 kg/m, 25-30 kg/m (overweight), and ≥30 kg/m (obesity). Time-varying Cox regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). The PAF was estimated based on age- and sex-adjusted HRs and the prevalence of BMI categories in VTE cases.
At baseline, the prevalence of overweight and obesity was 37.9 and 13.8%, respectively. During a median follow-up of 13.9 years, 1,051 VTEs occurred. The age- and sex-adjusted HRs of VTE were 1.40 (95% CI: 1.21-1.61) for overweight and 1.86 (95% CI: 1.58-2.20) for obesity compared with subjects with BMI <25 kg/m. The PAF of VTE due to overweight and obesity was 24.6% (95% CI: 16.6-32.9), with 12.9% (95% CI: 6.6-19.0) being attributed to overweight and 11.7% (95% CI: 8.5-14.9) to obesity. Similar PAFs were obtained in analyses stratified by sex and VTE subtypes (provoked/unprovoked events, deep vein thrombosis, pulmonary embolism).
Our findings indicate that almost 25% of all VTE events can be attributed to overweight and obesity in a general population from Norway.
肥胖是静脉血栓栓塞症（VTE）的一个公认的危险因素。然而，关于普通人群中超重和肥胖导致的 VTE 比例的数据有限。
在一个基于人群的队列中，通过对体重指数（BMI）进行重复测量，研究 VTE 归因于超重和肥胖的人群归因分数（PAF）。
来自特罗姆瑟研究第四次至第七次调查（入组时间：1994-2016 年）的参与者在 2020 年之前进行了随访，所有新发 VTE 均被记录。共有 36341 名独特的参与者被纳入研究，对于参加过一次以上调查的参与者，更新了 BMI 测量值。BMI 分为<25kg/m、25-30kg/m（超重）和≥30kg/m（肥胖）。使用时间依赖性 Cox 回归模型计算危险比（HR）及其 95%置信区间（CI）。根据年龄和性别调整后的 HR 和 VTE 病例中 BMI 类别的患病率，估计 PAF。
基线时，超重和肥胖的患病率分别为 37.9%和 13.8%。在中位随访 13.9 年期间，发生了 1051 例 VTE。与 BMI<25kg/m 的受试者相比，超重和肥胖的 VTE 年龄和性别调整后的 HR 分别为 1.40（95%CI：1.21-1.61）和 1.86（95%CI：1.58-2.20）。超重和肥胖导致 VTE 的 PAF 为 24.6%（95%CI：16.6-32.9），其中 12.9%（95%CI：6.6-19.0）归因于超重，11.7%（95%CI：8.5-14.9）归因于肥胖。在按性别和 VTE 亚型（诱发性/非诱发性事件、深静脉血栓形成、肺栓塞）分层的分析中，也得到了类似的 PAF。
我们的研究结果表明，在挪威的普通人群中，近 25%的所有 VTE 事件可归因于超重和肥胖。
