Association between obesity and venous thromboembolism

Abstract

Background and aims. Obesity is associated with numerous pathological conditions, including venous thromboembolism (VTE). VTE is a multifactorial disease; more than half of the hospitalized patients are at risk for VTE.
 We aimed to assess the risk of VTE associated with obesity, taking into account the class of obesity (according to the body mass index), gender, age and the intervention of other acquired risk factors.
 Method. A case-control study including 732 patients was designed. Collected data included: age, gender, body mass index, pregnancy/ postpartum state, use of hormonal therapy, personal and family history of VTE, smoking, prolonged immobilization and the presence of comorbidities- acquired risk factors for VTE. The risk of VTE was expressed as odds ratio (OR) with 95% confidence interval. Multiple logistic regression analysis was used to detect the independent risk factors. P value < 0.05 was considered significant statistic.
 Results. Obesity was associated with a 6.2- fold increased risk for VTE. The risk of VTE associated with obesity was highest in patients aged >50 years and in cases included in classes II and III of obesity. The interaction between obesity and another acquired risk factor has almost doubled the risk of VTE. Multivariate logistic regression analysis showed obesity as an independent risk factor for VTE for both female and male patients.
 Conclusion. Obesity is an independent and moderate risk factor for VTE. The risk increases with body mass index, age and the presence of other acquired risk factors.

Evaluation of Deep Vein Thrombosis Risk Factors After Arthroscopic Posterior Cruciate Ligament Reconstruction: A Retrospective Observational Study

“…For all we know, age has been identified as a VTE risk factor mainly due to the increased blood coagulability and prevalence of other predisposing factors such as immobilization and hospitalization. 28 , 30 , 31 In this study, an older age was weakly associated with a higher DVT risk, which suggested that age was still an unignorable factor in DVT prevention. D-dimer is widely used in clinical practice as an indicator to monitor DVT with a high sensitivity and specificity.…”

“… 23 Summarily, these existing research results ulteriorly illustrated that the low-grade inflammatory and impaired fibrinolysis state mediated by obesity itself was very likely to be a major reason for the increased risk of VTE. 25 , 28 , 29 Importantly, recent researches demonstrated that the abnormal expression of adipokines and microRNAs and the endothelial damage resulting from systemic oxidative stress could contribute to the pro inflammatory and prothrombotic effects exacerbated by excess body weight. 25 , 28 , 29 Although the specific association of a high BMI and VTE is still not clear, for the obese patients with PCL injury, there is quite a necessity to take some measures exactly as strengthening physical prevention, taking lipid-lowering medication, and anticoagulant intervention for a decrease in DVT incidence after knee arthroscopic PCL reconstruction.…”

Efficacy, Safety, and Exposure of Apixaban in Patients with High Body Weight or Obesity and Venous Thromboembolism: Insights from AMPLIFY

“…Obesity is a risk factor for thrombotic disorders, including venous thromboembolism (VTE), due to disruption of the balance between prothrombotic and antithrombotic adipokines, which leads to chronic inflammation, impaired fibrinolysis, and enhanced platelet activation inducing the coagulation cascade [2,3]. Studies have reported up to a 6.2-fold increase in the risk of VTE due to obesity [4][5][6].…”

Multi‐center retrospective study evaluating the efficacy and safety of apixaban versus warfarin for treatment of venous thromboembolism in patients with severe obesity

“…1,2 Among patients with obesity, defined as a body mass index (BMI) >30 kg/m 2 , there is a 6.2-fold increased risk for VTE. 3 This risk has been shown to have a direct correlation with an increasing BMI, placing patients with severe obesity, defined as a BMI >40 kg/m 2 , at even higher risk of VTE occurrence. 3 Direct oral anticoagulants (DOACs) are the standard of care for VTE treatment.…”