Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China.
Thromb Haemost. 2024 Jun;124(6):546-554. doi: 10.1055/a-2213-8939. Epub 2023 Nov 20.
The association between dietary manganese (Mn) intake and the risk of venous thromboembolism (VTE) remains unknown. We aimed to investigate the associations of dietary Mn intake with incident VTE, and the underlying mediating roles of obesity markers (body mass index [BMI] and waist circumference), hemorheological parameters (red cell distribution width [RDW], platelet count [PLT], and mean platelet volume [MPV]), and inflammatory biomarkers (C-reactive protein [CRP] and white blood cell count [WBC]) in this association.
A total of 202,507 adults from the UK Biobank with complete dietary data and without VTE at baseline were included. Dietary information was collected by the online 24-hour diet recall questionnaires (Oxford WebQ). The primary outcome was incident VTE, a composite of incident deep vein thrombosis (DVT) and pulmonary embolism (PE).
During a median follow-up of 11.6 years, 4,750 participants developed incident VTE. Overall, there were significantly inverse relationships of dietary Mn intake with incident VTE (per 1 mg/day increment; adjusted hazard ratio [HR]: 0.92; 95% confidence interval [CI]: 0.90-0.95), incident DVT (per 1 mg/day increment; adjusted HR: 0.93; 95% CI: 0. 90-0.96), and incident PE (per 1 mg/day increment; adjusted HR: 0.91; 95% CI: 0.88-0.95). BMI, waist circumference, RDW, CRP, and WBC significantly mediated the association between dietary Mn intake and incident VTE, with the mediated proportions of 36.0, 36.5, 4.2, 4.3, and 1.6%, respectively. However, MPV and PLT did not significantly mediate the association.
Our study shows that dietary Mn intake was inversely associated with incident VTE. The inverse association was mainly mediated by obesity, followed by inflammatory biomarkers and RDW. Our findings are just hypothesis-generating, and further confirmation of our findings in more studies is essential.
膳食锰（Mn）摄入与静脉血栓栓塞症（VTE）风险之间的关联尚不清楚。我们旨在研究膳食 Mn 摄入与 VTE 发病风险的相关性，并探讨肥胖标志物（体重指数 [BMI] 和腰围）、血液流变学参数（红细胞分布宽度 [RDW]、血小板计数 [PLT] 和平均血小板体积 [MPV]）和炎症生物标志物（C 反应蛋白 [CRP] 和白细胞计数 [WBC]）在该相关性中的潜在介导作用。
共纳入来自英国生物库的 202507 名成年人，这些成年人基线时无 VTE 且完成了完整的饮食数据采集。膳食信息通过在线 24 小时饮食回忆问卷（牛津网络问卷）收集。主要结局为 VTE 发病事件，包括深静脉血栓形成（DVT）和肺栓塞（PE）发病事件的复合终点。
在中位随访 11.6 年期间，4750 名参与者发生了 VTE 发病事件。总体而言，膳食 Mn 摄入与 VTE 发病事件（每增加 1mg/天；调整后的危险比 [HR]：0.92；95%置信区间 [CI]：0.90-0.95）、DVT 发病事件（每增加 1mg/天；调整后的 HR：0.93；95% CI：0.90-0.96）和 PE 发病事件（每增加 1mg/天；调整后的 HR：0.91；95% CI：0.88-0.95）之间存在显著的负相关关系。BMI、腰围、RDW、CRP 和 WBC 显著介导了膳食 Mn 摄入与 VTE 发病事件之间的关联，其介导比例分别为 36.0%、36.5%、4.2%、4.3%和 1.6%。然而，MPV 和 PLT 并未显著介导这种关联。
本研究表明，膳食 Mn 摄入与 VTE 发病风险呈负相关。这种负相关主要由肥胖介导，其次是炎症生物标志物和 RDW。我们的发现只是假设性的，需要在更多研究中进一步证实我们的发现。
