Varicose Veins and Deep Venous Thrombosis

Tiwari, Alok; Lester, Will; Tang, Tjun Yip

doi:10.1001/jama.2018.7319

Cited by 7 publications

(7 citation statements)

References 4 publications

(5 reference statements)

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“…When the proportional hazard assumption test was significant in the two first models thus meaning the effect were not constant and changed over the follow-up time. We investigated the material by breaking it up into shorter time span of 5 years (0-5, 5-10, [10][11][12][13][14][15][15][16][17][18][19][20]. All the different time spans showed proportionality except for the time span 0-5 years.…”

Section: Discussionmentioning

confidence: 99%

“…Unprovoked VTE shares some known risk factors with other cardiovascular diseases (CVDs) such as obesity, smoking [4][5][6][7] and sleep-apnoea [8][9][10]. Other risk factors for VTE include high body height [11] and varicose veins [1,[12][13][14][15]. Varicose veins and VTE has been suggested to share familial susceptibility [16] and a genetic component of the familial clustering has been found for VTE, which makes heredity a potent risk factor [17,18] The risk of VTE also increases with age, especially among men aged > 50 years [19,20].…”

Section: Introductionmentioning

confidence: 99%

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Self-rated health and venous thromboembolism among middle-aged women: a population-based cohort study

Nymberg

Stenman

Calling

et al. 2019

J Thromb Thrombolysis

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Venous thromboembolism (VTE) is one of the most common types of cardiovascular diseases (CVDs) and is associated with increased mortality-risk. Poor-self rated health (SHR) has been associated with elevated inflammatory markers and CVDs. However, little is known about as a predictor of incident VTE. To examine the association between self-rated health, lifestyle and incident VTE among middle-aged women. 6917 women aged 50-64 years, followed for 20 years in the Women's Health In the Lund Area (WHILA) study. After exclusion of those who medicated with anticoagulants, were living in nursing homes or suffered from cancer, stroke, VTE or CHD before baseline, a cohort of 5626 women remained. Cox regression was used to analyse the relationship between self-rated health and time to VTE, censored for any of the previous mentioned diseases during follow-up. Data were collected by questionnaires, physical examinations and Swedish registers. In total, 220 women were affected by VTE corresponding to an incidence rate of 3.9 per 1000 person-years. Adjustment for self-rated health did not significantly predict incident VTE, and neither did any of the lifestyle-related habits (e.g. physical activity and dietary habits including alcohol consumption), besides smoking. This study supports previous results with varicose veins and waist circumference as strong predictors of VTE. Poor self-rated health does not seem to be a valid predictor of VTE. Among lifestyle-related parameters, smoking was significantly associated with risk of VTE. We could also confirm the effect of the other already known risk factors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Self-rated health and venous thromboembolism among middle-aged women: a population-based cohort study

Nymberg

Stenman

Calling

et al. 2019

J Thromb Thrombolysis

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“…As a major kind of chronic venous disease, lower extremity varicose veins are very common, affecting approximately 23% of the US adult population ( 3 ). Currently, 22 million women and 11 million men aged 40-80 years in the US are suffering from this condition ( 3 , 4 ). The presence of lower extremity varicose veins not only impairs patients’ quality of life, but also increases the risk of venous complications, such as deep vein thrombosis, thrombophlebitis, skin changes, and chronic venous ulceration ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Sex hormone-binding globulin exerts sex-related causal effects on lower extremity varicose veins: evidence from gender-stratified Mendelian randomization

Fan,

Meng,

Nie

et al. 2023

Front. Endocrinol.

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BackgroundThe association between serum sex hormones and lower extremity varicose veins has been reported in observational studies. However, it is unclear whether the association reflects a causal relationship. Besides, serum sex hormone-binding globulin (SHBG) has been rarely studied in lower extremity varicose veins. Here, we aim to investigate the association between serum levels of SHBG, testosterone, and estradiol and the risk of lower extremity varicose veins using Mendelian randomization (MR).MethodsWe obtained genome-wide association study summary statistics for serum SHBG levels with 369,002 European participants, serum testosterone levels with 424,907 European participants, serum estradiol levels with 361,194 European participants, and lower extremity varicose veins with 207,055 European participants. First, a univariable MR was performed to identify the causality from SHBG and sex hormone levels to lower extremity varicose veins with several sensitivity analyses being performed. Then, a multivariable MR (MVMR) was performed to further assess whether the causal effects were independent. Finally, we performed a gender-stratified MR to understand the role of genders on lower extremity varicose veins.ResultsGenetically predicted higher serum SHBG levels significantly increased the risk of lower extremity varicose veins in the univariable MR analysis (OR=1.39; 95% CI: 1.13–1.70; P=1.58×10-3). Sensitivity analyses and MVMR (OR=1.50; 95% CI:1.13-1.99; P=5.61×10-3) verified the robustness of the causal relationships. Gender-stratified MR revealed that higher serum SHBG levels were associated with lower extremity varicose veins in both sexes. However, the OR of serum SHBG levels on lower extremity varicose veins risk in females (OR=1.51; 95% CI: 1.23–1.87; P=1.00×10-4) was greater than in males (OR=1.26; 95% CI: 1.04–1.54; P=1.86×10-2).ConclusionsSerum SHBG levels are positively related to lower extremity varicose veins risk in both sexes, especially in females. This may partly explain the higher prevalence of varicose vines among females.

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“…In addition to the shared risk, CVD and VTE predispose for each other, i.e., prevalent CVD increases the risk of incident VTE [7,8]. Obesity, with an increased waist circumference, is also a risk factor for metabolic syndrome [9], which increases the risk for varicose veins, VTE, CVD, and diabetes type II [1,[10][11][12][13][14]. According to a systematic review [15] with a meta-analysis of the result from five articles with a total of 8252 cases and 20,904 controls, low amount of mitochondria DNA copy number (mtDNA-CN) is a suggested risk indicator for CVDs.…”

Section: Introductionmentioning

confidence: 99%

Mitochondria-DNA copy-number and incident venous thromboembolism among middle-aged women: a population-based cohort study

Nymberg

Memon

Sundquist

et al. 2021

J Thromb Thrombolysis

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Venous thromboembolism (VTE) is the third most common cardiovascular disease. Low amount of mitochondrial DNA copy number (mtDNA-CN) has been associated with arterial cardiovascular disease (CVD) and reflects mitochondrial dysfunctions. However, whether mtDNA-CN is associated with VTE has not been determined. To examine the association between mtDNA-CN and incident VTE among middle-aged women. 6917 women aged 50–64 years, followed for 20 years in the Women’s Health In the Lund Area (WHILA) study. DNA samples for mtDNA quantification were available from 2521 women. Quantification of mtDNA-CN was performed using a well-optimized droplet digital PCR method. After exclusions of women with anticoagulant treatment, women living in nursing homes, and women who were diagnosed with cancer, stroke, VTE, or coronary heart disease at baseline, a cohort of 2117 women remained for analysis. Cox regression was used to analyze the relationship between mtDNA-CN and time to VTE (hazard ratio = HR). In total, 87 women were diagnosed with VTE during follow-up, corresponding to an incidence rate of 2.8 per 1000 person-years. Neither crude nor adjusted HR for mtDNA-CN were significantly associated with incident VTE. A sensitivity analysis with inclusion of excluded women did not change the results. MtDNA-CN was not significantly associated with VTE. The present study suggests that mtDNA-CN, reflecting mitochondrial dysfunction, should not be considered a biomarker that plays a major role for developing VTE. However, due to limited study size we may not exclude minor associations.

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Varicose Veins and Deep Venous Thrombosis

Cited by 7 publications

References 4 publications

Self-rated health and venous thromboembolism among middle-aged women: a population-based cohort study

Self-rated health and venous thromboembolism among middle-aged women: a population-based cohort study

Sex hormone-binding globulin exerts sex-related causal effects on lower extremity varicose veins: evidence from gender-stratified Mendelian randomization

Mitochondria-DNA copy-number and incident venous thromboembolism among middle-aged women: a population-based cohort study

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