血清白蛋白、遗传易感性与静脉血栓栓塞风险
Serum albumin, genetic susceptibility, and risk of venous thromboembolism.
作者信息
Sun Yuyang, Deng Jun, Ding Yajie, Luo Shanshan, Li Si, Guan Yunlong, Cao Xi, Hao Xingjie, Hu Yu
机构信息
Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
出版信息
Res Pract Thromb Haemost. 2024 Jul 14;8(5):102509. doi: 10.1016/j.rpth.2024.102509. eCollection 2024 Jul.
BACKGROUND
Previous research on the association between serum albumin (ALB) and venous thromboembolism (VTE) has produced inconclusive results. The polygenic risk score is constructed from a set of independent risk variants associated with a disorder, enabling the identification of a larger fraction of the population at comparable or greater disease risk. It is still unknown whether ALB and genetic factors jointly contribute to the incidence of VTE.
OBJECTIVES
The present study aimed to explore ALB, genetic susceptibility, and the risk of VTE.
METHODS
The present investigation was an analysis of prospectively collected data from UK Biobank, a population-based, longitudinal cohort. Cox proportional models were used to calculate hazard ratios and 95% CIs for VTE. The Kaplan-Meier curve was utilized to visualize the cumulative risk of VTE according to different serum ALB levels, and the restricted cubic spline model was leveraged to explore the exposure-response relationship among ALB levels and VTE risk.
RESULTS
During median follow-up of 13.5 years, 11,502 cases with VTE were diagnosed among 417,113 participants in the UK Biobank. The lower ALB levels were associated with a higher risk for VTE. Individuals with both a high genetic risk and lowest ALB level had the highest risk of VTE (hazard ratio, 3.89; 95% CI, 3.41-4.43), compared with those with low genetic risk and highest ALB level. The positive joint effects of low ALB and polygenic risk score increased the risk of VTE in individuals with high genetic risk. This study excluded non-European patients and primarily focused on the European population, which may limit the generalizability of the findings.
CONCLUSION
Low serum ALB levels were linked to an increased risk of VTE, which was in accordance with a linear dose-response relationship. There was a positive additive effect of ALB and genetic susceptibility on the risk of VTE. ALB could serve as a biomarker for predicting the risk of VTE.
背景
先前关于血清白蛋白（ALB）与静脉血栓栓塞症（VTE）之间关联的研究结果尚无定论。多基因风险评分由一组与疾病相关的独立风险变异构建而成，能够识别出更大比例的具有相当或更高疾病风险的人群。目前仍不清楚ALB和遗传因素是否共同影响VTE的发病率。
目的
本研究旨在探讨ALB、遗传易感性与VTE风险之间的关系。
方法
本研究分析了英国生物银行前瞻性收集的数据，这是一个基于人群的纵向队列。采用Cox比例模型计算VTE的风险比和95%置信区间。利用Kaplan-Meier曲线直观展示不同血清ALB水平下VTE的累积风险，并使用受限立方样条模型探讨ALB水平与VTE风险之间的暴露-反应关系。
结果
在英国生物银行的417,113名参与者中，中位随访13.5年期间，共诊断出11,502例VTE病例。较低的ALB水平与较高的VTE风险相关。与遗传风险低且ALB水平高者相比，遗传风险高且ALB水平最低的个体发生VTE的风险最高（风险比为3.89；95%置信区间为3.41-4.43）。低ALB和多基因风险评分的正向联合作用增加了遗传风险高的个体发生VTE的风险。本研究排除了非欧洲患者，主要关注欧洲人群，这可能会限制研究结果的普遍性。
结论
低血清ALB水平与VTE风险增加相关，且呈线性剂量反应关系。ALB和遗传易感性对VTE风险具有正向相加作用。ALB可作为预测VTE风险的生物标志物。
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