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Thromb Haemost 2024; 124(10): 962-970
DOI: 10.1055/s-0044-1786970
Stroke, Systemic or Venous Thromboembolism

Obesity-Related Traits Mediate the Effects of Educational Attainment on the Risk of Varicose Veins, Venous Thromboembolism, and Phlebitis

Hong-Cheng Du
1   Graduate School of Guangxi University of Chinese Medicine, Nanning, China
,
Bai-Yang Deng
2   Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
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Letter to:

Educational Attainment, Obesity, and Venous Thromboembolism. Is Only Matter of Weight?Thromb Haemost 2024; 124(10): 971-972
DOI: 10.1055/s-0044-1788904

Abstract

Background The extent to which educational attainment (EA) influences the risk of varicose veins (VVs), venous thromboembolism (VTE), and phlebitis occurrence, whether this pathway is mediated by obesity-related traits, and the proportion of their mediation is unknown.

Methods A Mendelian randomization (MR) design was used to genetically investigate the causal effects of EA on the risk of VV, VTE, and phlebitis and to assess the mediating effect of obesity-related traits. Causal effects were estimated using primarily the multiplicative random-effects inverse variance-weighted method. This was supplemented by Cochran's Q-statistic, MR–Egger regression, MR funnel plots, and leave-one-out test to evaluate the reliability of the results. For the individual mediation effect, the coefficient product method was mainly utilized to estimate.

Results An increase in genetically predicted EA was associated with a lower risk of VV, VTE, and phlebitis, as well as lower body mass index, basal metabolic rate, hip circumference, and waist circumference. As genetically predicted body mass index, basal metabolic rate, hip circumference, and waist circumference increased, the risk of developing VV, VTE, and phlebitis increased, respectively. Body mass index, basal metabolic rate, hip circumference, and waist circumference were identified as mediators of the protective effects of EA on VV, VTE, and phlebitis.

Conclusion The findings support a causal relationship between higher EA and lower risk of VV, VTE, and phlebitis. Obesity-related traits play a significant mediating role in these pathways, and there are interactions between them, with hip circumference mediating these pathways relatively independently from the other three.

Keywords

educational attainment - obesity - varicose veins - venous thromboembolism - phlebitis

Authors' Contribution

Guiding the research process: B.-Y.D. Conceptualization and methodology, study design, data collection, statistical analysis, and writing (original draft): H.-C.D. Writing (review and editing) and approval of final manuscript: All authors.


Supplementary Material



Publication History

Received: 06 November 2023

Accepted: 18 April 2024

Article published online:
10 May 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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