Glucose levels and diabetes are not associated with the risk of venous thrombosis: results from the <scp>MEGA</scp> case‐control study

Li‐Gao, Ruifang; Morelli, Vânia M.; Lijfering, Willem M.; Cannegieter, Suzanne C.; Rosendaal, Frits R.; Vlieg, Astrid van Hylckama

doi:10.1111/bjh.15599

Cited by 12 publications

(14 citation statements)

References 14 publications

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“…Studies have reported conflicting results on diabetes. Two metaanalyses and a more recently published case-control study found no association between diabetes and the risk of VTE, 26,34,54 which is consistent with our finding. However, three other meta-analyses concluded that diabetes was associated with a small increased risk of VTE, 15,29,30 albeit in one study, the association disappeared after further adjustment for traditional cardiovascular risk factors (obesity, hypertension, dyslipidemia, being sedentary, or smoking).…”

Section: Discussionsupporting

confidence: 92%

Association between cardiovascular risk factors and venous thromboembolism in the elderly

Wang

Rosendaal

Cushman

et al. 2022

Research and Practice in Thrombosis and Haemostasis

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Background The preponderance of the evidence supports no association between traditional cardiovascular risk factors and venous thromboembolism (VTE), other than obesity. There are limited data in older people. Objectives To investigate whether cardiovascular risk factors (body mass index, smoking, alcohol intake, hypertension, and diabetes) are associated with the risk of VTE in elderly and to assess the combined effect between cardiovascular risk factors and genetic risk factors for VTE (factor V Leiden/prothrombin 20210A, positive family history of VTE, and non‐O blood group). Methods The Age and Thrombosis, Acquired and Genetic risk factors in the Elderly study is a multicenter case‐control study performed in Vermont, USA and Leiden, the Netherlands, comprising 401 cases with first VTE and 431 control subjects, all aged ≥70 years. To assess the risk of VTE, odds ratios (OR) with 95% confidence intervals (CIs) were calculated, adjusting for potential confounders. Results Both height and weight were positively associated with VTE risk: the ORs were 2.2 (95% CI, 1.2–3.9) and 1.5 (95% CI, 1.0–2.4) in the top quartile for height and weight separately. This risk was more pronounced for unprovoked VTE. Smoking, alcohol intake, and diabetes were not associated with VTE. Higher systolic and diastolic blood pressure and hypertension were associated with a decreased risk of VTE. In the presence of a genetic predisposition, height and weight further increased the risk of VTE. Conclusions In the elderly, height and weight are positively associated with the risk of VTE. With genetic predisposition, higher levels of height and weight further increase the risk of VTE.

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Section: Discussionsupporting

confidence: 92%

Association between cardiovascular risk factors and venous thromboembolism in the elderly

Wang

Rosendaal

Cushman

et al. 2022

Research and Practice in Thrombosis and Haemostasis

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“…These coagulation factor levels were lower in diabetic patients, who were treated with glucose‐lowering therapies. This might explain the discrepancy in risk of VT in diabetic patients between studies and emphasizes the clinical importance of glucose regulation. The time frame between elevated coagulation factors and the possible development of VT is unclear.…”

Section: Discussionmentioning

confidence: 96%

“…1 Diabetes is a risk factor for arterial complications, 2 but conflicting results have been published regarding the association with venous thrombosis (VT). [3][4][5][6][7] Yet, meta-analyses showed an 1.4-fold increased risk of VT in diabetes. 3,4 Also, several studies reported an association between pre-diabetes and VT, [8][9][10][11] but these studies are scarce, had heterogeneous designs, included stress-induced hyperglycemia, adjusted for few confounding factors, and did not explain the underlying mechanism sufficiently.…”

Section: Introductionmentioning

confidence: 99%

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Glucose metabolism affects coagulation factors: The NEO study

Toorn

Mutsert

Lijfering

et al. 2019

Journal of Thrombosis and Haemostasis

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Background It is insufficiently understood if there is an association between diabetes and VT, and what the underlying mechanism would be. Objectives We aimed to study the association between glucose concentrations with several coagulation factors in the general population. Methods This is a cross‐sectional analysis of baseline measurements within 5778 participants of the Netherlands Epidemiology of Obesity (NEO) study, a population‐based cohort study of individuals 45 to 65 years. Associations between fasting glucose and HbA1c concentrations, and postprandial glucose response and factor (F) VIII, FIX, FXI, and fibrinogen levels were examined using linear regression analyses and by calculating mean levels per category of glucose concentrations while adjusting for confounding factors. Results Per each mmol/L higher fasting glucose concentration we observed higher levels of fasting FVIII (5.33%, 95% CI: 4.00‐6.65), FIX (6.19%, 95% CI: 5.15‐7.23), and FXI (2.11%, 95% CI: 1.20‐3.02). Results for fasting HbA1c and postprandial glucose response were similar. Participants with an impaired fasting glucose, high fasting glucose, and diabetes mellitus had higher mean levels of FVIII, FIX, and FXI than those with a normal glucose metabolism, with the highest differences in the levels of FVIII, FIX, and FXI between a high fasting glucose and a normal glucose metabolism. All associations attenuated after adjustment for total body fat, yet all of the above associations remained after adjustment for the confounding factors, except for fibrinogen when contrasted to glucose. Conclusion Concentrations of fasting glucose and HbA1c and postprandial glucose response were positively associated with FVIII, FIX, and FXI, and to some extent also with fibrinogen.

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“…Patients with diabetes mellitus have a hypercoagulable state that may increase their risk for thromboembolism, such as microvascular occlusive disease. However, some studies showed no association between diabetes mellitus and the incidence of venous thrombosis [ 17 , 18 ]. This was not an independent risk factor for PVT in this study.…”

Section: Discussionmentioning

confidence: 99%

A practical nomogram based on systemic inflammatory markers for predicting portal vein thrombosis in patients with liver cirrhosis

et al. 2022

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Introduction Immunothrombosis has recently been used to describe the responses/mechanisms in thrombosis. Systemic inflammatory markers are prognostic markers for a variety of thrombotic conditions; however, their potential value in predicting portal vein thrombosis (PVT) is unknown. This study aimed to establish an easy-to-use nomogram based on systemic inflammatory markers to predict portal vein thrombosis (PVT) in patients with liver cirrhosis. Patients and methods This retrospective study included 478 patients with cirrhosis between January 2013 and January 2021. Reputed systemic inflammatory markers (systemic immune-inflammation index [SII], neutrophil-to-lymphocyte ratio [NLR], monocyte-to-lymphocyte ratio [MLR], and platelet-to-lymphocyte ratio (PLR)) were measured, and the clinical data were recorded. The independent risk factors for PVT were determined using univariate analyses and multivariate logistic regression analyses, and a nomogram to predict the occurrence of PVT was established. The concordance index, receiver operating characteristic curves, and calibration plots were used to evaluate the performance of the model. Results A total of 239 patients with PVT and 239 patients without PVT were selected. In the univariate analysis, high SII, NLR, PLR, and MLR were significantly associated with PVT. NLR and PLR were independent risk factors for PVT ( P < 0.05) by multivariate analysis. The nomogram had good predictive efficiency for PVT in patients with cirrhosis, with an area under the receiver operating characteristic (AUROC) curves of 0.891 (95% CI 0.862–0.919) and the calibration curves fit as well, indicating that the nomogram had good clinical application value. Conclusions PVT in patients with cirrhosis is associated with increased levels of systemic inflammatory markers. We successfully developed a practical nomogram based on NLR and PLR to accurately predict PVT, which is a practical method helping clinicians rapidly and conveniently diagnose and guide the treatment of PVT in patients with cirrhosis. Key Messages The present study is the first report on a nomogram based on systemic inflammatory markers in patients with portal vein thrombosis (PVT). The nomogram had good predictive efficiency and a good clinical application value for predicting PVT in patients with cirrhosis.

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Glucose levels and diabetes are not associated with the risk of venous thrombosis: results from the MEGA case‐control study

Cited by 12 publications

References 14 publications

Association between cardiovascular risk factors and venous thromboembolism in the elderly

Association between cardiovascular risk factors and venous thromboembolism in the elderly

Glucose metabolism affects coagulation factors: The NEO study

A practical nomogram based on systemic inflammatory markers for predicting portal vein thrombosis in patients with liver cirrhosis

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