Thromb Haemost 2013; 110(03): 593-597
DOI: 10.1160/TH13-01-0048
Cardiovascular Biology and Cell Signalling
Schattauer GmbH

Body mass index, a major confounder to insulin resistance association with unprovoked venous thromboembolism

Results from the EDITH case-control study
Aurélien Delluc
1   Université de Bretagne Occidentale, EA 3878, Brest, France
2   CHRU Brest, Département de Médecine Interne et Pneumologie, Brest, France
,
Claire De Moreuil
1   Université de Bretagne Occidentale, EA 3878, Brest, France
2   CHRU Brest, Département de Médecine Interne et Pneumologie, Brest, France
,
Hélène Kerspern
3   CHU Brest, Hôpital Cavale Blanche, Department of Biochemistry and Pharmacology, Brest, France
,
Emmanuelle Le Moigne
1   Université de Bretagne Occidentale, EA 3878, Brest, France
2   CHRU Brest, Département de Médecine Interne et Pneumologie, Brest, France
,
Dominique Mottier
1   Université de Bretagne Occidentale, EA 3878, Brest, France
4   INSERM, CIC 0502, Brest, France
,
Cécile Tromeur
1   Université de Bretagne Occidentale, EA 3878, Brest, France
2   CHRU Brest, Département de Médecine Interne et Pneumologie, Brest, France
,
Jean-Luc Carre
3   CHU Brest, Hôpital Cavale Blanche, Department of Biochemistry and Pharmacology, Brest, France
,
Grégoire Le Gal
1   Université de Bretagne Occidentale, EA 3878, Brest, France
4   INSERM, CIC 0502, Brest, France
,
Karine Lacut
1   Université de Bretagne Occidentale, EA 3878, Brest, France
4   INSERM, CIC 0502, Brest, France
› Institutsangaben
Financial Support: The study was supported by grants from the INSERM (Contrat de Recherche Stratégique 2001, CRES N°4CR05G), from Région Bretagne (Programme 1044-04013235 n°1440), the Programme Hospitalier de Recherche Clinique 2000, and IFR 148. The Centre Hospitalier Régional et Universitaire de Brest promoted the study. The funders of this study had no role in the design or conduct of the study; in the collection analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript.
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Publikationsverlauf

Received: 21. Januar 2013

Accepted after major revision: 07. Juni 2013

Publikationsdatum:
22. November 2017 (online)

Summary

Shared risk factors help explain the association between venous thromboembolism (VTE) and atherothrombosis. The potential association between insulin resistance and VTE has been poorly evaluated. Thus, we aimed to assess the association between insulin resistance and VTE in the EDITH hospital-based case-control study. Between May 2000 and December 2004, 677 patients with unprovoked VTE and their age- and sex-matched controls were included. Fasting glycaemia and insulinaemia were measured and insulin resistance was estimated with the homeostasis model assessment of insulin resistance (HOMAIR) equation. The association between HOMA-IR and VTE was determined in non-diabetic patients in a quintile-based analysis. A total of 590 non-diabetic cases (median age 73.0 years, 255 men) and 581 non-diabetic controls (median age 72.0 years, 247 men) were analysed. There was a trend for a higher median level of HOMA-IR index in cases than in controls (1.21 [interquartile range 0.84-2.10] vs 1.19 [interquartile range 0.72-2.02], p=0.08). The unadjusted analysis showed an increased risk of unprovoked VTE associated with increasing HOMA-IR (odds ratio [OR] 1.53; 95% confidence interval [CI] 1.00-2.34 for the highest quintile of HOMA-IR compared with the first quintile). Adjustment for lipid lowering drugs and antiplatelet agents use slightly modified the association (OR 1.51; 95% CI 0.97-2.34). When body mass index was added in the adjusted model, HOMA-IR was no longer associated with VTE (OR 1.08; 95% CI 0.67-1.73). Our results highlight the role of body mass index in the association between cardiovascular risk factors and VTE.

 
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