Hematocrit and Incidence of Venous Thromboembolism

Background. Polycythemia vera patients with high hematocrit have increased risk of venous thromboembolism (VTE). We tested whether high hematocrit in the general population is also associated with elevated VTE risk. Methods. The prospective Atherosclerosis Risk in Communities (ARIC) Study performed a complete blood count in 13,891 adults aged 45-64 at baseline in 1987-89. We identified and validated incident hospitalized VTEs through 2015, with provoked VTE defined as occurring within 90 days of surgery, trauma, immobilization or with cancer. We performed proportional hazards regression analyses using race-sex specific categorization of hematocrit percentiles (i.e., <5, 5-24.9, 25-74.9, 75-94.9, and 95-100 percentiles, with the 25-74.9th percentile serving as the reference group). Results. At baseline, higher hematocrit was associated with smoking prevalence, greater pack years smoked, higher body-mass index and higher prevalence of diabetes. With 26 years median follow-up, 800 participants had incident deep vein thrombosis of the leg and/or pulmonary embolism. The figure shows a J-shaped association of hematocrit with VTE incidence. The VTE incidence at the highest level of hematocrit was approximately double that at the mid level. Low hematocrit also was associated with elevated VTE incidence but the confidence interval overlapped 1. The Table shows modeling results. Accounting for other risk factors, the risk of overall VTE was elevated 72% for participants above the 95th percentile of hematocrit compared with the reference. Specifically, hazard ratios (95% confidence interval) of incident VTE were 1.27 (0.91,1.76), 1.06 (0.87,1.28), 1 (reference), 1.17 (0.98, 1.40) and 1.72 (1.30, 2.27) across the five hematocrit percentiles, adjusted for age, race, sex, body mass index, and other potential confounding variables including smoking status and pack-years. The association of high hematocrit with VTE was limited to provoked VTE, with little evidence for unprovoked VTE. Results were similar for hemoglobin (not shown). Discussion. High hematocrit and hemoglobin in a general middle-aged population sample were associated with increased long-term risk of VTE, particularly provoked VTE. The reasons for this pattern require further study. Disclosures No relevant conflicts of interest to declare.

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Circulating Microparticles and Risk of Venous Thromboembolism.

Blood ◽

10.1182/blood.v114.22.3987.3987 ◽

2009 ◽

Vol 114 (22) ◽

pp. 3987-3987

Author(s):

Paolo Bucciarelli ◽

Emanuele Previtali ◽

Ida Martinelli ◽

Andrea Artoni ◽

Serena M Passamonti ◽

...

Keyword(s):

Body Mass Index ◽

Venous Thromboembolism ◽

Body Mass ◽

Plasma Levels ◽

Conflicts Of Interest ◽

Factor V Leiden ◽

Control Group ◽

Dependent Manner ◽

Healthy Controls ◽

Increased Risk

Abstract Abstract 3987 Poster Board III-923 Background Microparticles (MPs) are circulating, submicroscopic fragments (<1 μm of diameter) of membrane-bound cytoplasm that shed from the surface of an activated or apoptotic cell and play a role in coagulation, inflammation, cell remodelling and proliferation. There is increasing evidence that MPs are involved in thrombosis, but whether or not they are an independent risk factor for venous thromboembolism (VTE) is not established. Aim of the study To investigate the association between high plasma levels of MPs and risk of VTE Patients and Methods In a case-control study, 186 patients with a first episode of VTE (deep venous thrombosis and/or pulmonary embolism) and 418 healthy controls were included. MPs were analyzed by flow cytometry with a gate defined by a 1 μm beads and using APC-Annexin V together with FITC anti-CD41 or FITC anti-CD142 antibodies in order to identify platelet MPs (MP-Plts) and MPs exposing tissue factor (MP-TF), respectively. MPs levels were expressed as number/μL. Results Patients had significantly higher median plasma levels of both MPs-Plts and MPs-TF than controls [1942 vs 1519 (p<0.0001) and 579 vs 454 (p<0.0001)]. Higher median levels of MP-Plts and MP-TF were found in 41 patients who underwent blood sampling within 6 months from VTE than in those sampled later [2114 vs 1694 (p=0.086) and 652 vs 543 (p=0.120)]. Sex, age, body mass index and factor VIII plasma levels had no influence on MPs levels, as well as the use of oral contraceptives (this latter evaluated only in controls). In the whole study population, carriership of thrombophilia (antithrombin, protein C or protein S deficiency, factor V Leiden, prothrombin G20210A, antiphospholipid antibodies, hyperhomocysteinemia or combined abnormalities) had higher levels of MP-Plts and MP-TF than non-carriers [1907 vs 1565 (p=0.002) and 532 vs 468 (p=0.011)]. The odds ratio (OR) for VTE, adjusted for sex, age, body mass index and thrombophilia was 2.5-fold higher in individuals with MPs plasma levels >95th percentile of the control group (3633/μL for MPs-Plts and 1113/μL for MPs-TF) than in those with MPs levels ≤95th percentile [for MPs-Plts: OR=2.59 (95%CI 1.23 – 5.45); for MPs-TF: OR=2.38 (1.15 – 4.92)]. The risk increased in a dose-dependent manner for both MPs-Plts and MPs-TF, particularly above the 75th percentile of the distribution in controls. The exclusion of patients whose MPs levels were measured within 6 months from VTE (in order to avoid the possible effect of the acute phase on MPs measurements), did not change the results [adjusted OR: 2.63 (1.18 – 5.89) for MPs-Plts and 2.36 (1.10 – 5.19) for MPs-TF]. The Table shows the relative risks of VTE associated with the presence or absence of high MPs levels and thrombophilia. Individuals with MPs >95th percentile or thrombophilia alone had a 2 to 3-fold increased risk of VTE, whereas those with both MPs-Plts >95th percentile and thrombophilia had a 9-fold increased risk of VTE. This synergistic effect was confirmed also for MPs-TF and remained after the exclusion of patients whose blood sample was collected within 6 months from VTE [OR 7.72 (1.68-35.4) for MP-Plts and 8.14 (2.08-31.8) for MP-TF]. Conclusions Plasma levels of MPs are significantly higher in patients with VTE than in healthy controls. MPs levels >95th percentile are associated with a 2.5-fold increased risk of VTE. There is a synergistic interaction between high levels of MPs and thrombophilia on VTE risk. Disclosures: No relevant conflicts of interest to declare.

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Physical activity modifies the risk of atrial fibrillation in obese individuals: The HUNT3 study

European Journal of Preventive Cardiology ◽

10.1177/2047487318784365 ◽

2018 ◽

Vol 25 (15) ◽

pp. 1646-1652 ◽

Cited By ~ 14

Author(s):

Lars E Garnvik ◽

Vegard Malmo ◽

Imre Janszky ◽

Ulrik Wisløff ◽

Jan P Loennechen ◽

...

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Body Mass Index ◽

Confidence Interval ◽

Body Mass ◽

High Body Mass Index ◽

Overweight And Obesity ◽

Hazard Ratio ◽

Increased Risk

Background Atrial fibrillation is the most common heart rhythm disorder, and high body mass index is a well-established risk factor for atrial fibrillation. The objective of this study was to examine the associations of physical activity and body mass index and risk of atrial fibrillation, and the modifying role of physical activity on the association between body mass index and atrial fibrillation. Design The design was a prospective cohort study. Methods This study followed 43,602 men and women from the HUNT3 study in 2006–2008 until first atrial fibrillation diagnosis or end of follow-up in 2015. Atrial fibrillation diagnoses were collected from hospital registers and validated by medical doctors. Cox proportional hazard regression analysis was performed to assess the association between physical activity, body mass index and atrial fibrillation. Results During a mean follow-up of 8.1 years (352,770 person-years), 1459 cases of atrial fibrillation were detected (4.1 events per 1000 person-years). Increasing levels of physical activity were associated with gradually lower risk of atrial fibrillation ( p trend 0.069). Overweight and obesity were associated with an 18% (hazard ratio 1.18, 95% confidence interval 1.03–1.35) and 59% (hazard ratio 1.59, 95% confidence interval 1.37–1.84) increased risk of atrial fibrillation, respectively. High levels of physical activity attenuated some of the higher atrial fibrillation risk in obese individuals (hazard ratio 1.53, 95% confidence interval 1.03–2.28 in active and 1.96, 95% confidence interval 1.44–2.67 in inactive) compared to normal weight active individuals. Conclusion Overweight and obesity were associated with increased risk of atrial fibrillation. Physical activity offsets some, but not all, atrial fibrillation risk associated with obesity.

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The Association Between Body Mass Index and Pancreatic Cancer: Variation by Age at Body Mass Index Assessment

American Journal of Epidemiology ◽

10.1093/aje/kwz230 ◽

2019 ◽

Vol 189 (2) ◽

pp. 108-115 ◽

Cited By ~ 2

Author(s):

Eric J Jacobs ◽

Christina C Newton ◽

Alpa V Patel ◽

Victoria L Stevens ◽

Farhad Islami ◽

...

Keyword(s):

Pancreatic Cancer ◽

Body Mass Index ◽

Confidence Interval ◽

Body Mass ◽

Proportional Hazards ◽

Middle Age ◽

Epidemiologic Studies ◽

Excess Weight ◽

Hazard Ratios ◽

Increased Risk

Abstract Higher body mass index (BMI; weight (kg)/height (m)2) is associated with increased risk of pancreatic cancer in epidemiologic studies. However, BMI has usually been assessed at older ages, potentially underestimating the full impact of excess weight. We examined the association between BMI and pancreatic cancer mortality among 963,317 adults who were aged 30–89 years at their enrollment in Cancer Prevention Study II in 1982. During follow-up through 2014, a total of 8,354 participants died of pancreatic cancer. Hazard ratios per 5 BMI units, calculated using proportional hazards regression, declined steadily with age at BMI assessment, from 1.25 (95% confidence interval: 1.18, 1.33) in persons aged 30–49 years at enrollment to 1.13 (95% confidence interval: 1.02, 1.26) in those aged 70–89 years at enrollment (P for trend = 0.005). On the basis of a hazard ratio of 1.25 per 5 BMI units at age 45 years, we estimated that 28% of US pancreatic cancer deaths among persons born in 1970–1974 will be attributable to BMI ≥25.0—nearly twice the equivalent proportion of those born in the 1930s, a birth cohort with much lower BMI in middle age. These results suggest that BMI before age 50 years is more strongly associated with pancreatic cancer risk than BMI at older ages, and they underscore the importance of avoiding excess weight gain before middle age for preventing this highly fatal cancer.

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Abstract P253: Body Mass Index and Heart Failure among Patients with Type 2 Diabetes

Circulation ◽

10.1161/circ.131.suppl_1.p253 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Gang Hu ◽

Peter Katzmarzyk ◽

Ronald Horswell ◽

Yujie Wang ◽

Jolene Johnson ◽

...

Keyword(s):

Heart Failure ◽

Type 2 Diabetes ◽

Body Mass Index ◽

Body Mass ◽

Reference Group ◽

Smoking Status ◽

Positive Association ◽

University Hospital ◽

Diabetic Patients

Background: Epidemiologic data on the association between body mass index (BMI) and heart failure (HF) risk among diabetic patients is rare. Aim: To investigate the association between BMI and HF risk among patients with type 2 diabetic in the Louisiana State University Hospital-based Longitudinal study (LSUHLS). Methods: We performed a prospective cohort study of risk for HF among 31,155 patients of type 2 diabetes (11,468 men and 19,687 women). Cox proportional hazards regression models were used to estimate the association of different levels of BMI with HF risk. Results: During a mean follow-up of 7.8 years, 5,834 subjects developed HF (2,379 men and 3,455 women). The multivariable-adjusted (age, race, smoking, income and type of insurance) hazard ratios of HF associated with BMI levels (18.5-22.9, 23-24.9, 25-29.9 [reference group], 30-34.9, 35-39.9, and ≥40 kg/m2) at baseline were 0.95, 1.00, 1.00, 1.16, 1.64, and 2.02 (Ptrend <0.001) for men, and 1.16, 1.16, 1.00, 1.23, 1.55, and 2.01 (Pnon-linear <0.001) for women, respectively. When we used an updated mean value of BMI, the association of HF risk with BMI did not change. When stratified by age, race, smoking status and use of anti-diabetic drugs, the positive association among men and the J-shaped association among women were still present. Conclusions: Our study suggests a positive association between BMI and HF risk among men, and a J-shaped association between BMI and HF risk among women with type 2 diabetes.

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The effect of obesity on incidence of disability and mortality in Mexicans aged 50 years and older

Salud Pública de México ◽

10.21149/spm.v57s1.7587 ◽

2015 ◽

Vol 57 ◽

pp. 31 ◽

Cited By ~ 7

Author(s):

Soham Al Snih ◽

Amit Kumar ◽

Amol M Karmarkar ◽

Alai Tan ◽

James E Graham ◽

...

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Confidence Interval ◽

Activities Of Daily Living ◽

Body Mass ◽

Daily Living ◽

Smoking Status ◽

Complete Data ◽

Hazard Ratio ◽

Aging Study

Objective. To examine the effect of obesity on incidence of disability and mortality among non-disabled older Mexicans at baseline. Materials and methods. The sample included 8 415 Mexicans aged ≥ 50 years from the Mexican Health and Aging Study (2001-2012), who reported no limitations in activities of daily living (ADLs) at baseline and have complete data on all covariates. Sociodemographics, smoking status, comorbidities, ADL activities, and body mass index (BMI) were collected. Results. The lowest hazard ratio (HR) for disability was at BMI of 25 to < 30 (HR = 0.97; 95% confidence interval [CI], 0.85-1.12). The lowest HR for mortality were seen among participants with BMIs 25 to < 30 (HR = 0.85; 95%CI, 075-0.97), 30 to < 35 (HR = 0.86; 95 %CI, 0.72-1.02), and ≥ 35 (HR = 0.92; 95 %CI, 0.70-1.22). Conclusion. Mexican older adults with a BMI of 25 to < 30 were at less risk for both disability and mortality.

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Higher body mass index at ages 16 to 20 years is associated with increased risk of a multiple sclerosis diagnosis in subsequent adulthood among men

Multiple Sclerosis Journal ◽

10.1177/1352458520928061 ◽

2020 ◽

Vol 27 (1) ◽

pp. 147-150 ◽

Cited By ~ 1

Author(s):

Yin Xu ◽

Ayako Hiyoshi ◽

Judith S Brand ◽

Kelsi A Smith ◽

Shahram Bahmanyar ◽

...

Keyword(s):

Multiple Sclerosis ◽

Body Mass Index ◽

Confidence Interval ◽

Physical Fitness ◽

Body Mass ◽

Normal Weight ◽

Overweight And Obesity ◽

Military Conscription ◽

Increased Risk ◽

Multiple Sclerosis Diagnosis

Background: Evidence for the association between body mass index (BMI) and multiple sclerosis (MS) among men remains mixed. Objective and methods: Swedish military conscription and other registers identified MS after age of 20 years and BMI at ages 16–20 years ( N = 744,548). Results: Each unit (kg/m2) BMI increase was associated with greater MS risk (hazard ratio and 95% confidence interval = 1.034, 1.016–1.053), independent of physical fitness (1.021, 1.001–1.042). Categorised, overweight and obesity were associated with statistically significant raised MS risk compared to normal weight, but not after adjustment for physical fitness. Conclusion: MS risk rises with increasing BMI, across the entire BMI range.

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Association between obesity and venous thromboembolism

Medicine and Pharmacy Reports ◽

10.15386/mpr-1372 ◽

2020 ◽

Author(s):

Cristina Hotoleanu

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Venous Thromboembolism ◽

Body Mass ◽

Logistic Regression Analysis ◽

The Body ◽

Increased Risk

Background and aims. Obesity is associated with numerous pathological conditions, including venous thromboembolism (VTE). VTE is a multifactorial disease; more than half of the hospitalized patients are at risk for VTE. We aimed to assess the risk of VTE associated with obesity, taking into account the class of obesity (according to the body mass index), gender, age and the intervention of other acquired risk factors. Method. A case-control study including 732 patients was designed. Collected data included: age, gender, body mass index, pregnancy/ postpartum state, use of hormonal therapy, personal and family history of VTE, smoking, prolonged immobilization and the presence of comorbidities- acquired risk factors for VTE. The risk of VTE was expressed as odds ratio (OR) with 95% confidence interval. Multiple logistic regression analysis was used to detect the independent risk factors. P value < 0.05 was considered significant statistic. Results. Obesity was associated with a 6.2- fold increased risk for VTE. The risk of VTE associated with obesity was highest in patients aged >50 years and in cases included in classes II and III of obesity. The interaction between obesity and another acquired risk factor has almost doubled the risk of VTE. Multivariate logistic regression analysis showed obesity as an independent risk factor for VTE for both female and male patients. Conclusion. Obesity is an independent and moderate risk factor for VTE. The risk increases with body mass index, age and the presence of other acquired risk factors.

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The Association of Obesity and Liver Enzyme Activities in a Student Population at Increased Risk for Cardiovascular Disease / Veza Između Gojaznosti I Aktivnosti Jetrenih Enzima U Studentskoj Populaciji Sa Povećanim Rizikom Za Nastanak Kardiovaskularnih Bolesti

Journal of Medical Biochemistry ◽

10.2478/v10011-012-0024-z ◽

2013 ◽

Vol 32 (1) ◽

pp. 26-31 ◽

Cited By ~ 1

Author(s):

Emina Čolak ◽

Dragana Pap ◽

Nada Majkić-Singh ◽

Ivana Obradović

Keyword(s):

Body Mass Index ◽

Waist Circumference ◽

Liver Enzyme ◽

Body Mass ◽

Statistical Processing ◽

The Body ◽

Control Group ◽

Anthropometric Parameters ◽

Nonalcoholic Fatty Liver ◽

Increased Risk

Summary Background: It has been reported that obesity is associated with metabolic syndrome, insulin resistance, cardiovascular risk but also with nonalcoholic fatty liver disease (NAFLD). The prevalence of obesity in children and adolescents is increasing rapidly all over the world. The aim of this study was to analyze the value of liver enzymes: AST, ALT and γGT in a group of obese students in order to establish their correlation to anthropometric parameters such as: BMI (body mass index), WC (waist circumference), HC (hip circumference), and WHR (waist-to-hip ratio) compared to non-obese students who comprised the control group (CG). Methods: In this study, 238 students from the University of Novi Sad of both sexes (126 men and 112 women) with a mean age of 22.32 ± 1.85 years were included. According to the body mass index (BMI) lower and higher than 25 kg/m2 and waist circumference (WC) lower and higher than 94 cm (80 cm for females) the whole group of 238 students was divided into 2 subgroups: the obese group at increased risk for CVD (Group 1) and the group at lower risk for CVD (Group 2). AST, ALT and γGT activities were determined in fasting blood samples. Results: Statistical processing data revealed significantly higher values of AST, ALT and γGT in the group of students with BMI>25 kg/m2, WC>94 cm for males and WC>80 cm for females, HC>108 cm for males and HC>111 cm for females, and WHR>0.90 for males and WHR>0.80 for females (P<0.001). Significant association was established between anthropometric parameters and liver enzyme levels (P<0.0001). Conclusions: Obese students with higher BMI, WC, HC and WHR values have higher liver enzyme activites and a higher chance to develop NAFLD in the future.

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Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study

Scientific Reports ◽

10.1038/s41598-021-83367-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

So-Ryoung Lee ◽

Kyung-Do Han ◽

Eue-Keun Choi ◽

Seil Oh ◽

Gregory Y. H. Lip

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Body Mass ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver ◽

Increased Risk ◽

The Impact

AbstractWe evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046–1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106–1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.

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Association between body mass index and 1-year outcome after acute myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.1409 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

D.W Kim

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Body Mass Index ◽

Confidence Interval ◽

Body Mass ◽

Cardiac Death ◽

Funding Source ◽

Group Iii ◽

End Point ◽

Group I

Abstract Background Beneficial effects of overweight and obesity on mortality after acute myocardial infarction (AMI) have been described as “Body Mass Index (BMI) paradox”. However, the effects of BMI is still on debate. We analyzed the association between BMI and 1-year major cardiocerebrovascular events (MACCE) after AMI. Methods and findings Among 13,104 AMI patients registered in an Institute of Health in Korea between November 2011 and December 2015, 10,568 patients who eligible for this study were classified into 3 groups according to BMI (Group I; <22 kg/m2, 22 ≤ Group II <26 kg/m2, Group III; ≥26 kg/m2). The primary end point was a composite of cardiac death (CD), myocardial infarction (MI), target vessel revascularization (TVR), and cerebrovascular events at 1 year. Over the median follow-up of 12 months, the composite of primary end point occurred more frequently in the Group I patients than in the Group III patients (primary endpoint: adjusted hazard ratio [aHR], 1.290; 95% confidence interval [CI] 1.024 to 1.625, p=0.031). Especially, cardiac death in MACCE components played a major role in this effect (aHR, 1.548; 95% confidence interval [CI] 1.128 to 2.124, p=0.007). Conclusions Higher BMI appeared to be good prognostic factor on 1-year MACCE after AMI. This result suggests that higher BMI or obesity might confer a protective advantage over the life-quality after AMI. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Research of Korea Centers for Disease Control and Prevention and the Korea Health Technology R&D Project, Ministry of Health & Welfare (HI13C1527), Republic of Korea.

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