1
|
Li Y, Wang X, Zhang X, Chen Q, Shi X, Zhang B, Xu J, Han B. Associations between genetically predicted TIMP-3 levels and risk of venous thromboembolism: A two sample Mendelian randomization study. J Pharm Biomed Anal 2024; 248:116290. [PMID: 38878456 DOI: 10.1016/j.jpba.2024.116290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 05/26/2024] [Accepted: 06/04/2024] [Indexed: 07/20/2024]
Abstract
TIMP metallopeptidase inhibitor 3 (TIMP-3) may contribute to the pathogenesis of venous thromboembolism (VTE). However, few studies have investigated the effect of TIMP-3 on VTE. Therefore, a two-sample Mendelian randomization (MR) analysis was conducted to investigate the association between TIMP-3 levels and VTE. Seven independent single-nucleotide polymorphisms (SNPs) for TIMP-3 levels were obtained from a published genome-wide association study (the KORA Consortium, including 997 Europeans). We obtained outcome datasets for VTE, pulmonary embolism (PE), and deep vein thrombosis (DVT) from the FinnGen Consortium. The primary analytical method used in the MR analysis was the inverse variance weighted (IVW) method. To enhance the robustness of the MR results, some other MR methods including weighted median, MR-Egger, and MR-PRESSO were conducted. Moreover, several sensitivity analyses were performed to identify potential horizontal pleiotropy and heterogeneity. In primary IVW MR analyses, per log increase in genetically predicted TIMP-3 levels were positively associated with the incidence of VTE (odds ratio [OR], 1.03; 95 % confidence interval (CI), 1.01, 1.06; P = 0.010), PE (OR, 1.04; 95 % CI, 1.01, 1.08; P = 0.009), and DVT (OR, 1.06; 95 % CI, 1.02, 1.10; P= 0.003). The results of the weighted median, MR-Egger, and MR-PRESSO were similar to the main findings. No unbalanced pleiotropy or heterogeneity was observed. The study suggests that genetically predicted high levels of TIMP-3 may be associated with an increased risk of VTE. These findings indicate that strategies targeting TIMP-3 may provide a basis for the prevention and treatment of VTE. Further investigation is required to clarify this potential mechanism.
Collapse
Affiliation(s)
- Yang Li
- Department of Internal Medicine-Cardiovascular, The Second Hospital of Jiaxing, Jiaxing, China
| | - Xiaoyu Wang
- Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, China
| | - Xiangyu Zhang
- Department of Internal Medicine-Cardiovascular, The Second Hospital of Jiaxing, Jiaxing, China
| | - Qianqian Chen
- Department of Medicine, The Second Hospital of Jiaxing, Jiaxing, China
| | - Xiaowen Shi
- Cardiovascular Disease Laboratory, The Second Hospital of Jiaxing, Jiaxing, China
| | - Bin Zhang
- Department of Internal Medicine-Cardiovascular, The Second Hospital of Jiaxing, Jiaxing, China
| | - Jianjiang Xu
- Department of Internal Medicine-Cardiovascular, The Second Hospital of Jiaxing, Jiaxing, China.
| | - Bingjiang Han
- Department of Internal Medicine-Cardiovascular, The Second Hospital of Jiaxing, Jiaxing, China.
| |
Collapse
|
2
|
Yang D, Wang L. The radiological diagnosis of pregnancy associated venous thromboembolism: a review of current research. Front Med (Lausanne) 2024; 11:1394012. [PMID: 39234042 PMCID: PMC11373350 DOI: 10.3389/fmed.2024.1394012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 08/05/2024] [Indexed: 09/06/2024] Open
Abstract
One of the main causes of unfavorable pregnancy outcomes in expectant mothers is pregnancy-associated venous thromboembolism. Although pregnancy-related venous thromboembolism does not always manifest obvious clinical symptoms and lacks a comprehensive standard risk assessment and prediction system as well as simple and effective laboratory testing techniques, timely and accurate diagnosis can still help reduce the probability of adverse pregnancy outcomes. To aid in the early detection, diagnosis, and treatment of pregnancy- associated venous thromboembolism, we attempt to provide an overview of the radiological diagnostic techniques for various forms of the condition.
Collapse
Affiliation(s)
- Di Yang
- Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University (Changzhou Maternity and Child Health Care Hospital), Changzhou, China
| | - Li Wang
- Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University (Changzhou Maternity and Child Health Care Hospital), Changzhou, China
| |
Collapse
|
3
|
Fan HY, Hsu HY, Lin HJ, Chen YY, Chen YC, Su TC, Chien KL. Systolic blood pressure as a critical mediator in the association between adult height and 25-year risk of stroke. Obes Res Clin Pract 2024; 18:124-130. [PMID: 38570284 DOI: 10.1016/j.orcp.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 03/01/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Adult height is associated with the risk of stroke. However, the underlying mechanism remains unclear. We explored the mediating role of metabolic factors in the association between adult height and stroke incidence. METHODS We used data from 3306 community-dwelling participants with complete information on adult height, metabolic factors, and 25-year cardiovascular outcomes. Participants were classified into three adult height groups based on sex-specific height quartiles: short (Q1), average (Q2-Q3), and tall (Q4). The primary endpoint was the occurrence of cardiovascular disease, including coronary artery disease and stroke. RESULTS Taller adult height was associated with a lower risk of stroke. Compared with the short group the risk of stroke reduced with taller height with a hazard ratio (HR) of 0.68 in the average group (95% confidence interval [CI]: 0.50-0.93), and 0.45 in the tall group (95% CI: 0.31-0.65). Low systolic blood pressure was considered as a protective mediator in the effect of adult height on the risk of stroke in the average (HR: 0.86; 95% CI: 0.82-0.93) and the tall group (HR: 0.85; 95% CI: 0.78-0.91). Systolic blood pressure significantly contributed to height-related stroke risk (proportion mediated: 0.41; 95% CI: 0.19-1.56). CONCLUSIONS This study found an inverse association between adult height and stroke risk, which is partly driven by lower systolic blood pressure. These findings highlight the importance of systolic blood pressure management as a potential preventive strategy against stroke.
Collapse
Affiliation(s)
- Hsien-Yu Fan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Hsin-Yin Hsu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan; Department of Family Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Hung-Ju Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yun-Yu Chen
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan; Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan; Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
| | - Ta-Chen Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
4
|
Constantinescu AE, Bull CJ, Goudswaard LJ, Zheng J, Elsworth B, Timpson NJ, Moore SF, Hers I, Vincent EE. A phenome-wide approach to identify causal risk factors for deep vein thrombosis. BMC Med Genomics 2023; 16:284. [PMID: 37951941 PMCID: PMC10640748 DOI: 10.1186/s12920-023-01710-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
Deep vein thrombosis (DVT) is the formation of a blood clot in a deep vein. DVT can lead to a venous thromboembolism (VTE), the combined term for DVT and pulmonary embolism, a leading cause of death and disability worldwide. Despite the prevalence and associated morbidity of DVT, the underlying causes are not well understood. Our aim was to leverage publicly available genetic summary association statistics to identify causal risk factors for DVT. We conducted a Mendelian randomization phenome-wide association study (MR-PheWAS) using genetic summary association statistics for 973 exposures and DVT (6,767 cases and 330,392 controls in UK Biobank). There was evidence for a causal effect of 57 exposures on DVT risk, including previously reported risk factors (e.g. body mass index-BMI and height) and novel risk factors (e.g. hyperthyroidism and varicose veins). As the majority of identified risk factors were adiposity-related, we explored the molecular link with DVT by undertaking a two-sample MR mediation analysis of BMI-associated circulating proteins on DVT risk. Our results indicate that circulating neurogenic locus notch homolog protein 1 (NOTCH1), inhibin beta C chain (INHBC) and plasminogen activator inhibitor 1 (PAI-1) influence DVT risk, with PAI-1 mediating the BMI-DVT relationship. Using a phenome-wide approach, we provide putative causal evidence that hyperthyroidism, varicose veins and BMI enhance the risk of DVT. Furthermore, the circulating protein PAI-1 has a causal role in DVT aetiology and is involved in mediating the BMI-DVT relationship.
Collapse
Affiliation(s)
- Andrei-Emil Constantinescu
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK.
- Bristol Medical School, Population Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK.
- School of Translational Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK.
| | - Caroline J Bull
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- School of Translational Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Health Data Research UK. Registered Office, 215 Euston Road, London, NW1 2BE, UK
| | - Lucy J Goudswaard
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Jie Zheng
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Benjamin Elsworth
- Our Future Health Ltd. Registered office: 2 New Bailey, 6 Stanley Street, Manchester, M3 5GS, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - Samantha F Moore
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
- UKRI Medical Research Council, Swindon, UK
| | - Ingeborg Hers
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Emma E Vincent
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- School of Translational Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| |
Collapse
|
5
|
Abstract
Venous thromboembolism, that consists of the interrelated conditions deep-vein thrombosis and pulmonary embolism, is an under-appreciated vascular disease. In Western regions, approximately 1 in 12 individuals will be diagnosed with venous thromboembolism in their lifetime. Rates of venous thromboembolism are lower in Asia, but data from other regions are sparse. Numerous risk factors for venous thromboembolism have been identified, which can be classified as acute or subacute triggers (provoking factors that increase the risk of venous thromboembolism) and basal or acquired risk factors (which can be modifiable or static). Approximately 20% of individuals who have a venous thromboembolism event die within 1 year (although often from the provoking condition), and complications are common among survivors. Fortunately, opportunities exist for primordial prevention (prevention of the development of underlying risk factors), primary prevention (management of risk factors among individuals at high risk of the condition) and secondary prevention (prevention of recurrent events) of venous thromboembolism. In this Review, we describe the epidemiology of venous thromboembolism, including the incidence, risk factors, outcomes and opportunities for prevention. Meaningful health disparities exist in both the incidence and outcomes of venous thromboembolism. We also discuss these disparities as well as opportunities to reduce them.
Collapse
Affiliation(s)
- Pamela L Lutsey
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Neil A Zakai
- Division of Hematology/Oncology, Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| |
Collapse
|
6
|
Zhang Q, Zhang X, Zhang J, Jiang M, Zhang Y, Zheng D, Wu L, Wang W, Wang B, Wang Y. Genetic association and causal inference between lung function and venous thromboembolism. Respir Res 2023; 24:36. [PMID: 36717884 PMCID: PMC9885683 DOI: 10.1186/s12931-023-02335-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 01/18/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Previous studies have indicated that lower lung function is related to a higher risk of venous thromboembolism (VTE). However, causal inferences may be affected by confounders, coheritability or reverse causality. We aimed to explore the causal association between lung function and VTE. METHODS Summary data from public genome-wide association studies (GWAS) for lung function and VTE were obtained from published meta-analysis studies and the FinnGen consortium, respectively. Independent genetic variables significantly related to exposure were filtered as proxy instruments. We adopted linkage disequilibrium score regression (LDSC) and two-sample Mendelian randomization (MR) analyses to infer the genetic backgrounds and causal associations between different lung functions and VTE events. RESULTS LDSC showed a genetic correlation between forced expiratory volume in one second (FEV1) and deep vein thrombosis (DVT) (rg = - 0.189, P = 0.005). In univariate MR (UVMR), there was suggestive evidence for causal associations of genetically predicted force vital capacity (FVC) with DVT (odds ratio (OR) 0.774; 95% confidence interval (CI) 0.641-0.934) via forwards analysis and genetically predicted pulmonary embolism (PE) with FVC (OR 0.989; 95% CI 0.979-0.999) via reverse analysis. Multivariate MR (MVMR) analyses of lung function-specific SNPs suggested no significant direct effects of lung function on VTE, and vice versa. Of note is the borderline causal effect of PE on FEV1 (OR 0.921; 95% CI 0.848-1.000). CONCLUSIONS Our findings identified a coheritability of FEV1 (significant) and FVC (suggestive) with DVT. There was no convincing causal relationship between lung function and the risk of VTE events. The borderline causal effect of PE on FEV1 and the significant genetic correlation of FEV1 with DVT may have clinical implications for improving the quality of existing prevention and intervention strategies.
Collapse
Affiliation(s)
- Qiaoyun Zhang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China ,grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Xiaoyu Zhang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China ,grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Jie Zhang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China
| | - Mengyang Jiang
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Yiqiang Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Deqiang Zheng
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China
| | - Lijuan Wu
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China
| | - Wei Wang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China ,grid.1038.a0000 0004 0389 4302Centre for Precision Medicine, Edith Cowan University, Joondalup, WA Australia
| | - Baoguo Wang
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Youxin Wang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China ,grid.1038.a0000 0004 0389 4302Centre for Precision Medicine, Edith Cowan University, Joondalup, WA Australia
| |
Collapse
|
7
|
Krieg S, Kostev K, Luedde M, Krieg A, Luedde T, Roderburg C, Loosen SH. The association between the body height and cardiovascular diseases: a retrospective analysis of 657,310 outpatients in Germany. Eur J Med Res 2022; 27:240. [DOI: 10.1186/s40001-022-00881-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
Cardiovascular disease (CVD) represents the leading cause of death worldwide. The identification of individuals at increased risk of CVD is essential to reduce its morbidity and mortality globally. Based on existing data on a potential association between the individual body height and the risk for CVD, we investigated this association in a large cohort of outpatients in Germany.
Methods
A total of 657,310 adult outpatients with available body height data from the Disease Analyzer (IQVIA) database were included in Germany between 2019 and 2021. The prevalence of common CVD diagnoses (hypertension, coronary heart disease, atrial fibrillation and flutter, heart failure, ischemic stroke, and venous thromboembolism) was evaluated as a function of the patients’ body height stratified by age and sex.
Results
In both sexes, the prevalence of hypertension, coronary heart disease, heart failure, and ischemic stroke was higher among patients of smaller body height. In contrast, the prevalence of atrial fibrillation and venous thromboembolism was higher in taller patients. In age- and BMI-adjusted logistic regression analyses, an increased body height was negatively associated with coronary heart disease (OR = 0.91 in women and OR = 0.87 in men per 10-cm increase in height) and strongly positively associated with atrial fibrillation (OR = 1.25 in women and men) and venous thromboembolism (OR = 1.23 in women and OR = 1.24 in men).
Conclusion
We present the first data from a large cohort of outpatients in Germany providing strong evidence for an association between the body height and common CVD. These data should stimulate a discussion as to how far the body height should be implemented as a parameter in stratification tools to assess CVD risk in order to further reduce cardiovascular morbidity and mortality in the future.
Collapse
|
8
|
Zhang Q, Zhang X, Zhang J, Wang B, Tian Q, Meng X, Zhang J, Jiang M, Zhang Y, Zheng D, Wu L, Wang W, Wang B, Wang Y. Vascular endothelial growth factor and the risk of venous thromboembolism: a genetic correlation and two-sample Mendelian randomization study. Thromb J 2022; 20:67. [DOI: 10.1186/s12959-022-00427-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 10/22/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
The relationship between vascular endothelial growth factor (VEGF) and the risk of venous thromboembolism (VTE) has always been one of the concerns in the medical field. However, the causal inferences from published observational studies on this issue may be affected by confounders or reverse causality. We performed a two-sample bidirectional Mendelian randomization (MR) to infer the associations between VEGF and VTE.
Methods
Summary statistics from genome-wide association studies (GWAS) for VEGF and VTE were obtained from published meta-analysis studies and the FinnGen consortium, respectively. Independent genetic variables significantly associated with exposure were selected as instrumental variables. Linkage disequilibrium score regression (LDSC) and five robust MR analytical approaches were conducted to estimate the genetic correlations and causal inference. The MR-Egger intercept, Cochran’s Q, and MR pleiotropy residual sum and outlier (MR-PRESSO) were performed to evaluate the horizontal pleiotropy, heterogeneities, and stability of these genetic variants on outcomes. Notably, replication analyses were performed using different subgroups of VTE.
Results
LDSC failed to identify genetic correlations between VEGF and VTE. Based on 9 SNPs, the circulating VEGF level was positively related to the risk of VTE using inverse variance weighting (IVW) method (odds ratio (OR) = 1.064, 95% confidence interval (CI), 1.009–1.122). Reverse MR analyses showed that genetic liability for VTE was not associated with increased VEGF level (β = -0.021, 95% CI, -0.087-0.045). Pleiotropy-robust methods indicated no bias in any estimates.
Conclusions
Our findings failed to detect coheritability between VEGF and VTE. The suggestive positive effect of the higher VEGF level on the VTE risk may have clinical implications, suggesting that VEGF as a possible predictor and therapeutic target for VTE prevention need to be further warranted.
Collapse
|
9
|
Han F, Zhang C, Xuan M, Xie Z, Zhang K, Li Y. Effects of Hyperthyroidism on Venous Thromboembolism: A Mendelian Randomization Study. J Immunol Res 2022; 2022:2339678. [PMID: 36277472 PMCID: PMC9581675 DOI: 10.1155/2022/2339678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/11/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Observational studies show the correlation between thyroid dysfunction and risk of venous thromboembolism. However, the causal effects remain uncertain. Our study was conducted to evaluate whether thyroid function and dysfunction were causally linked to the risk of venous thromboembolism. Methods Publicly available summary data of thyrotropin (TSH) and free thyroxine (FT4), hypothyroidism, and hyperthyroidism were obtained from the ThyroidOmics Consortium and the UK Biobank. With single nucleotide polymorphisms (SNPs) as instrumental variables, the casual effects of genetically predicted TSH and FT4 and hypo- and hyperthyroidism on venous thromboembolism outcome were estimated through Mendelian randomization analysis methods (inverse variance weighted (IVW), MR-Egger, weighted median, simple mode, and weighted mode). Cochran's Q test was performed to evaluate the heterogeneity and horizontal pleiotropy. Results Our study selected 15 FT4-, 36 TSH-, 3 hyperthyroidism-, and 79 hypothyroidism-associated SNPs as instrumental variables. The IVW analysis results showed that the odds ratio of venous thromboembolism for hyperthyroidism was 1.124 (95% confidence interval: 1.019-1.240; p = 0.019), demonstrating the casual effect of hyperthyroidism not FT4, TSH, and hypothyroidism on venous thromboembolism. No heterogeneity or horizontal pleiotropy was observed according to Cochran's Q test. Conclusion Our Mendelian randomization analysis supports the causal effect of hypothyroidism on risk of venous thromboembolism. There is no evidence that genetically predicted TSH, FT4, and hypothyroidism have casual effects on venous thromboembolism. Future studies should be conducted to elucidate the underlying pathophysiological mechanisms.
Collapse
Affiliation(s)
- Fushi Han
- Department of Nuclear Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Chunyang Zhang
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Miao Xuan
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Zhuangli Xie
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Kunming Zhang
- Department of Oncology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Ying Li
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| |
Collapse
|
10
|
Li R, Chen Z, Gui L, Wu Z, Miao Y, Gao Q, Diao Y, Li Y. Varicose Veins and Risk of Venous Thromboembolic Diseases: A Two-Sample-Based Mendelian Randomization Study. Front Cardiovasc Med 2022; 9:849027. [PMID: 35498031 PMCID: PMC9047357 DOI: 10.3389/fcvm.2022.849027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background Varicose veins are found to be associated with increased risk of venous thromboembolism (VTE) in many observational studies, but whether varicose veins are causally associated with VTE remains unclear. Therefore, we used a series of Mendelian randomization (MR) methods to investigate that association. Methods 23 independent single-nucleotide polymorphisms (SNPs) for varicose veins were obtained from the Pan UK Biobank analysis. The outcomes datasets for deep vein thrombosis (DVT), pulmonary embolism (PE) and venous thromboembolism (VTE) were obtained from the FinnGen study. Before analysis, body mass index (BMI) and height were included as confounders in our MR model. Basic MR [inverse-variance weighted (IVW), weight-median, penalized weighted-median and MR-Egger methods] and MR-PRESSO were performed against each outcome using the whole SNPs and SNPs after excluding those associated with confounders. If causal associations were suggested for any outcome, a basic MR validation analysis, a multivariable MR analysis with BMI and height, a Causal Analysis Using Summary Effect estimates (CAUSE), and a two-step MR analysis with BMI and height, would follow. Results Using 21 qualified SNPs, the IVW method (OR: 1.173, 95% CI: 1.070-1.286, p < 0.001, FDR = 0.002), the weighted median method (OR: 1.255, 95% CI: 1.106-1.423, p < 0.001, FDR = 0.001), the penalized weighted median method (OR: 1.299, 95% CI: 1.128-1.495, p < 0.001, FDR = 0.001) and the MR-PRESSO (OR: 1.165, 95% CI: 1.067-1.273, p = 0.003, FDR = 0.009) suggested potential causal effect of varicose veins on DVT, but no cause effect was found for PE and VTE. Excluding SNPs associated with confounders yielded similar results. The causal association with DVT was validated using a self-reported DVT cohort (IVW, OR: 1.107, 95% CI: 1.041-1.178, p = 0.001). The causal association maintained after adjustment for height (OR = 1.105, 95% CI: 1.028-1.188, p = 0.007), BMI (OR = 1.148, 95% CI: 1.059-1.244, p < 0.001) and them both (OR = 1.104, 95% CI: 1.035-1.177, p = 0.003). The causal association also survived the strict CAUSE (p = 0.018). Finally, in two-step MR, height and BMI were found to have causal effects on both varicose veins and DVT. Conclusion Genetically predicted varicose veins may have a causal effect on DVT and may be one of the mediators of obesity and taller height that predispose to DVT.
Collapse
Affiliation(s)
- Ruihao Li
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Zuoguan Chen
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Liang Gui
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Zhiyuan Wu
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuqing Miao
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Qing Gao
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Yongpeng Diao
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yongjun Li
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School of Peking Union Medical College, Beijing, China
| |
Collapse
|
11
|
Liu Z, Mi J. Serum Albumin and Circulating Metabolites and Risk of Venous Thromboembolism: A Two-Sample Mendelian Randomization Study. Front Nutr 2021; 8:712600. [PMID: 34859025 PMCID: PMC8631825 DOI: 10.3389/fnut.2021.712600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/06/2021] [Indexed: 12/23/2022] Open
Abstract
Background and Aim: Previous observational studies indicated that the serum albumin levels and circulating metabolites are associated with a high risk of venous thromboembolism (VTE). However, whether these observations reflect causality remained unclear. Hence, we conducted a two-sample Mendelian randomization (MR) analysis to evaluate the causal associations of serum albumin and circulating metabolites with the risk of VTE. Methods and Results: Summary statistics of genetic instruments proxying serum albumin, total protein, and common circulating metabolites were extracted from genome-wide association studies in the European ancestry. Summary-level results of age- and sex-adjusted estimates for associations of the instruments with VTE were derived from the FinnGen consortium. We used the inverse-variance weighted (IVW) method as the primary analysis for univariable MR. Sensitivity analyses were performed to detect horizontal pleiotropy and outliers. Genetically proxied high-serum albumin and total protein levels were suggestive protective factor of VTE, with odds ratio (OR) = 0.69 (CI 0.54-0.89, p = 4.7 × 10-3) and 0.76 (CI 0.61-0.95, p = 0.015), respectively. Genetically proxied low-monounsaturated fatty acids and the ratio of monounsaturated fatty acid to total fatty acid are causally associated with increased risk of VTE, with ORs = 0.89 (CI 0.80-0.99, p = 0.031) and 0.85 (CI 0.78-0.94, p = 9.92 × 10-4), respectively. There is no indication of causal associations between other circulating metabolites and the risk of VTE. Conclusions: Genetically liability to low-serum albumin and total protein levels, low proxied monounsaturated fatty acids (MUFAs) and the ratio of MUFAs to total fatty acids are associated with the higher risk of VTE.
Collapse
Affiliation(s)
- Zhengye Liu
- Second School of Clinical Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jiarui Mi
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
12
|
Genetically predicted body composition in relation to cardiometabolic traits: a Mendelian randomization study. Eur J Epidemiol 2021; 36:1157-1168. [PMID: 34195880 DOI: 10.1007/s10654-021-00779-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/22/2021] [Indexed: 12/25/2022]
Abstract
Fat mass and fat-free mass are found to be associated with different health outcomes in observational studies, but the underlying causality remains unclear. We aimed to investigate the causal relationships between body composition and cardiometabolic traits using a two-sample Mendelian randomization (MR) approach. Independent genetic variants associated with body fat mass, fat-free mass, and fat percentage in UK Biobank population were used as genetic instrumental variables, and their causal effects on circulatory diseases, type 2 diabetes, glycemic traits, and lipid fractions were estimated from large-scale genome-wide association studies (GWAS) in European populations. Univariable, multivariable, and bidirectional MR analyses were performed. Genetically predicted high fat mass and fat percentage significantly increased risks of most cardiometabolic diseases, and high fat-free mass had protective effects on most cardiometabolic diseases after accounting for fat mass. Fat mass, fat-free mass, and fat percentage were all positively associated with higher risks of atrial fibrillation and flutter, varicose veins, and deep vein thrombosis and pulmonary embolism. High fat mass increased fasting glucose, homeostasis model assessment-insulin resistance (HOMA-IR), triglycerides, decreased high-density lipoprotein cholesterol, and high fat-free mass reduced HOMA-IR, triglycerides, and low-density lipoprotein cholesterol. Genetically predicted fat-free mass was bidirectionally negatively associated with 2-h glucose and total cholesterol. The findings may be helpful in risk stratification and tailoring management of body composition in patients with different cardiometabolic statuses.
Collapse
|
13
|
Hussien DG, Villarreal JV, Panchbhavi V, Jupiter DC. Predisposing Factors for 30-Day Complications Following Achilles Tendon Repair. J Foot Ankle Surg 2021; 60:288-291. [PMID: 33461920 DOI: 10.1053/j.jfas.2020.08.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 08/30/2020] [Indexed: 02/03/2023]
Abstract
Certain risk factors for Achilles tendon repair complications, including tobacco use, diabetes mellitus, steroid use, and obesity, have been well-reviewed. This study analyzes the impact of a range of demographic factors on unique surgical complications within the 30-day postoperative period. We extracted data from the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2017 and searched for Achilles tendon repairs using CPT codes 27650, 27652, and 27654, identifying 4,040 patients. Twenty-two demographic variables and their association with each of 4 complications were analyzed using t tests or chi-squared tests. A logistic regression was conducted to determine independent risk factors for each outcome, based on results from the bivariate analyses. Variables having p <.2 on bivariate analysis were included in the multivariate analysis of the corresponding surgical complication. Patients with open or infected wounds preoperatively were more likely to return with a postoperative surgical infection (p< .001). Likewise, each additional year of the patient's age increased their likelihood of developing a surgical infection (p= .03). Patients with "clean/contaminated" wound sites prior to repair were more likely to return for an additional service (p= .02). Furthermore, each additional inch of the patient's height (p= .03) and every additional minute of operative time increased a patient's risk of developing a new-onset deep vein thrombosis (p= .01). This study offers providers a more complete picture of which preoperative characteristics affect Achilles tendon repair patients, directing management to reduce postoperative complication rates.
Collapse
Affiliation(s)
- Doha G Hussien
- Student, School of Medicine, The University of Texas Medical Branch, Galveston, TX.
| | - Joseph V Villarreal
- Student, School of Medicine, The University of Texas Medical Branch, Galveston, TX
| | - Vinod Panchbhavi
- Professor, Department of Orthopedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX
| | - Daniel C Jupiter
- Professor, Department of Orthopedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX; Associate Professor, Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, TX
| |
Collapse
|
14
|
Abstract
Venous disease is a term that broadly covers both venous thromboembolic disease and chronic venous disease. The basic pathophysiology of venous thromboembolism and chronic venous disease differ as venous thromboembolism results from an imbalance of hemostasis and thrombosis while chronic venous disease occurs in the setting of tissue damage because of prolonged venous hypertension. Both diseases are common and account for significant mortality and morbidity, respectively, and collectively make up a large health care burden. Despite both diseases having well-characterized environmental components, it has been known for decades that family history is an important risk factor, implicating a genetic element to a patient's risk. Our understanding of the pathogenesis of these diseases has greatly benefited from an expansion of population genetic studies from pioneering familial studies to large genome-wide association studies; we now have multiple risk loci for each venous disease. In this review, we will highlight the current state of knowledge on the epidemiology and genetics of venous thromboembolism and chronic venous disease and directions for future research.
Collapse
Affiliation(s)
- Richard A. Baylis
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine, CA
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, Seattle WA 98195, USA
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle WA 98101, USA
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle WA 98108, USA
| | - Derek Klarin
- Division of Vascular Surgery, University of Florida College of Medicine, Gainesville, FL
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Eri Fukaya
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine, CA
| |
Collapse
|
15
|
Adult height and risk of 50 diseases: a combined epidemiological and genetic analysis. BMC Med 2018; 16:187. [PMID: 30355295 PMCID: PMC6201543 DOI: 10.1186/s12916-018-1175-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/12/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Adult height is associated with risk of several diseases, but the breadth of such associations and whether these associations are primary or due to confounding are unclear. We examined the association of adult height with 50 diseases spanning multiple body systems using both epidemiological and genetic approaches, the latter to identify un-confounded associations and possible underlying mechanisms. METHODS We examined the associations for adult height (using logistic regression adjusted for potential confounders) and genetically determined height (using a two-sample Mendelian randomisation approach with height-associated genetic variants as instrumental variables) in 417,434 individuals of white ethnic background participating in the UK Biobank. We undertook pathway analysis of height-associated genes to identify biological processes that could link height and specific diseases. RESULTS Height was associated with 32 diseases and genetically determined height associated with 12 diseases. Of these, 11 diseases showed a concordant association in both analyses, with taller height associated with reduced risks of coronary artery disease (odds ratio per standard deviation (SD) increase in height ORepi = 0.80, 95% CI 0.78-0.81; OR per SD increase in genetically determined height ORgen = 0.86, 95% CI 0.82-0.90), hypertension (ORepi = 0.83, 95% CI 0.82-0.84; ORgen = 0.88, 95% CI 0.85-0.91), gastro-oesophageal reflux disease (ORepi = 0.85, 95% CI 0.84-0.86; ORgen = 0.94, 95% CI 0.92-0.97), diaphragmatic hernia (ORepi = 0.81, 95% CI 0.79-0.82; ORgen = 0.91, 95% CI 0.88-0.94), but increased risks of atrial fibrillation (ORepi = 1.42, 95% CI 1.38-1.45; ORgen = 1.33, 95% CI 1.26-1.40), venous thromboembolism (ORepi = 1.18, 95% CI 1.16-1.21; ORgen = 1.15, 95% CI 1.11-1.19), intervertebral disc disorder (ORepi = 1.15, 95% CI 1.13-1.18; ORgen = 1.14, 95% CI 1.09-1.20), hip fracture (ORepi = 1.19, 95% CI 1.12-1.26; ORgen = 1.27, 95% CI 1.17-1.39), vasculitis (ORepi = 1.15, 95% CI 1.11-1.19; ORgen = 1.20, 95% CI 1.14-1.28), cancer overall (ORepi = 1.09, 95% CI 1.08-1.11; ORgen = 1.06, 95% CI 1.04-1.08) and breast cancer (ORepi = 1.08, 95% CI 1.06-1.10; ORgen = 1.07, 95% CI 1.03-1.11). Pathway analysis showed multiple height-associated pathways associating with individual diseases. CONCLUSIONS Adult height is associated with risk of a range of diseases. We confirmed previously reported height associations for coronary artery disease, atrial fibrillation, venous thromboembolism, intervertebral disc disorder, hip fracture and cancer and identified potential novel associations for gastro-oesophageal reflux disease, diaphragmatic hernia and vasculitis. Multiple biological mechanisms affecting height may affect the risks of these diseases.
Collapse
|
16
|
Zöller B, Ji J, Sundquist J, Sundquist K. Body Height and Incident Risk of Venous Thromboembolism: A Cosibling Design. ACTA ACUST UNITED AC 2018; 10:CIRCGENETICS.116.001651. [PMID: 28874396 DOI: 10.1161/circgenetics.116.001651] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/29/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Body height has been associated with an increased risk of venous thromboembolism (VTE), but the association can be confounded with shared familial factors (genetic/environmental). A cosibling design is useful for deeper understanding about the relationship between VTE and height. METHODS AND RESULTS From Swedish national registry databases, we used a corelative design with full siblings alongside a general Swedish population sample. A cohort of male conscripts (n=1 610 870), born in 1951 to 1992 without previous VTE, was followed from enlistment (1969-2010) until 2012. Another cohort of first-time pregnant women (n=1 093 342) from the medical birth register, without previous VTE, was followed from first pregnancy (1982-2012) until 2012. Using the Multi-Generation Register, we identified all full-sibling pairs discordant for height. This cosibling design allowed for adjustment for familial factors (genetic/environmental). Compared with the tallest women (>185 cm) and men (>190 cm), there was a graded decreased risk by lower height for both men and women. The risk was lowest in women and men with the shortest stature (<155 and <160 cm, respectively): hazard ratios=0.31 (95% confidence interval, 0.22-0.42) and 0.35 (95% confidence interval, 0.22-0.55), respectively. There was a graded association also in the cosibling design comparing siblings with varying degree of discordance for height (reference was the taller sibling): ≥10 cm difference between brothers hazard ratios=0.69 (95% confidence interval, 0.61-0.78) and sisters hazard ratios=0.65 (95% confidence interval, 0.52-0.80), respectively. CONCLUSIONS Height is an independent predictor of VTE. The use of sibling pairs reduces the likelihood that familial confounding explains the results. The findings are important for the understanding of the pathogenesis of VTE.
Collapse
Affiliation(s)
- Bengt Zöller
- From the Center for Primary Health Care Research, Lund University, Malmö, Sweden.
| | - Jianguang Ji
- From the Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- From the Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kristina Sundquist
- From the Center for Primary Health Care Research, Lund University, Malmö, Sweden
| |
Collapse
|
17
|
Patel S, Topping A, Ye X, Zhang H, Canaud B, Carioni P, Marelli C, Guinsburg A, Power A, Duncan N, Kooman J, van der Sande F, Usvyat LA, Wang Y, Xu X, Kotanko P, Raimann JG. Association between Heights of Dialysis Patients and Outcomes: Results from a Retrospective Cohort Study of the International MONitoring Dialysis Outcomes (MONDO) Database Initiative. Blood Purif 2018; 45:245-253. [PMID: 29478048 DOI: 10.1159/000485162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Tall people have improved metabolic profiles and better cardiovascular outcomes, a relationship inverted in dialysis patients. We investigated the relationship between height and outcomes in incident hemodialysis (HD) patients commencing treatment in an analysis of the international Monitoring Dialysis Outcomes (MONDO) database. METHODS In this retrospective cohort study, we included incident HD patients commencing treatment between -January 1, 2006 and December 31, 2010 and investigated the association between height and mortality using the MONDO database. A 6-months baseline period preceded 2.5 years of follow-up, during which we recorded patient mortality. Patients were stratified in region-specific deciles of the respective database's population (Asia Pacific, North and South America, and Europe) and we developed Cox-proportional hazard models (additionally adjusted for age, gender, post-dialysis weight, eKt/V, albumin, interdialytic weight gain, phosphorus, and predialysis systolic blood pressure) for each database. RESULTS We studied 23,353 patients (62 ± 15 years old, 42% female, body mass index 26 ± 6 kg/m2, height 165 ± 10 cm). We found a trend of increasing hazard ratio of death (HR) with increasing height for Asia Pacific, Europe, and South America. In the fully adjusted models, for South America, we found a trend of increasing HR without significance among deciles >5. In Europe, deciles 8-10 had significantly increased HR. No clear trend was found in North America. CONCLUSION We found an increasing risk of death with increasing height in all regions, except North America. While the reasons remain unclear, further research may be warranted.
Collapse
Affiliation(s)
- Samir Patel
- Renal Research Institute, New York, New York, USA
| | | | - Xiaoling Ye
- Renal Research Institute, New York, New York, USA
| | - Hanjie Zhang
- Renal Research Institute, New York, New York, USA
| | | | | | | | | | - Albert Power
- Imperial College London, London, United Kingdom.,School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | | | - Jeroen Kooman
- Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Len A Usvyat
- Renal Research Institute, New York, New York, USA.,Fresenius Medical Care, Waltham, Massachusetts, USA
| | - Yuedong Wang
- University of California Santa Barbara, Santa Barbara, California, USA
| | - Xiaoqi Xu
- Fresenius Medical Care Asia-Pacific, Hong Kong, China
| | - Peter Kotanko
- Renal Research Institute, New York, New York, USA.,Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | |
Collapse
|
18
|
Schooling CM. Insights From the Positive Association of Height With Incident Venous Thromboembolism. ACTA ACUST UNITED AC 2017; 10:CIRCGENETICS.117.001911. [PMID: 28874397 DOI: 10.1161/circgenetics.117.001911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- C Mary Schooling
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China and City University of New York Graduate School of Public Health and Health Policy.
| |
Collapse
|