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Subcutaneous fat accumulation and BMI associated with risk for pulmonary embolism in patients with proximal deep vein thrombosis: a population study based on 23,796 consecutive autopsies

Ogren, M; Eriksson, H; Bergqvist, D and Sternby, Nils LU (2005) In Journal of Internal Medicine 258(2). p.166-171
Abstract
Objective. Although deep vein thrombosis (DVT) and pulmonary embolism (PE) are manifestations of the same disease, far from all patients develop PE. Our objective was to investigate risk-modifying factors. Setting, subjects and design. Between 1970 and 1982, 23 796 autopsies, representing 84% of all in-hospital deaths in the Malmo City population, were performed, using a standardized procedure. In a case-control study nested in a population-based cohort of patients with proximal DVT, the relationship between PE and body mass index (BMI), thoracic and abdominal subcutaneous (SC) fat thickness was evaluated. Results. Proximal DVT was found in 15%, of which 58% were women. Mean age in men was 4.5 years lower than in women (P < 0.001).... (More)
Objective. Although deep vein thrombosis (DVT) and pulmonary embolism (PE) are manifestations of the same disease, far from all patients develop PE. Our objective was to investigate risk-modifying factors. Setting, subjects and design. Between 1970 and 1982, 23 796 autopsies, representing 84% of all in-hospital deaths in the Malmo City population, were performed, using a standardized procedure. In a case-control study nested in a population-based cohort of patients with proximal DVT, the relationship between PE and body mass index (BMI), thoracic and abdominal subcutaneous (SC) fat thickness was evaluated. Results. Proximal DVT was found in 15%, of which 58% were women. Mean age in men was 4.5 years lower than in women (P < 0.001). Fifty per cent of the patients had PE, half of which were fatal. Similar age- and gender distribution was found in cases and controls. Patients in the upper tertile of BMI, abdominal and thoracic SC fat thickness had, in comparison with mid-tertile, and independent of age, gender and death from cancer disease, an increased odds (95% CI) for PE of 1.24 (1.04-1.47) (P = 0.014), 1.28 (1.07-1.53) (P = 0.006) and 1.35 (1.13-1.61) (P = 0.001), respectively, whereas in patients of the lower tertiles, a negative association was found. Conclusions. We found no differences in age- and gender distribution between PE cases and controls. BMI and SC fat thickness were markers of disease progression from proximal DVT to PE. The highly significant and independent association indicates that SC obesity may be of greater importance in venous thromboembolism as compared with cardiovascular diseases related to visceral (abdominal) obesity with lipid- and glucose metabolic disturbances. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
venous thromboembolism, embolism, pulmonary, obesity, epidemiology, adipose tissue, deep vein thrombosis
in
Journal of Internal Medicine
volume
258
issue
2
pages
166 - 171
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • wos:000230493100007
  • pmid:16018793
  • scopus:22644441020
ISSN
1365-2796
DOI
10.1111/j.1365-2796.2005.01517.x
language
English
LU publication?
yes
id
56ebe6d5-ba8f-42b7-a11e-aa296cf85efb (old id 233063)
date added to LUP
2007-10-05 11:24:26
date last changed
2017-01-01 07:09:23
@article{56ebe6d5-ba8f-42b7-a11e-aa296cf85efb,
  abstract     = {Objective. Although deep vein thrombosis (DVT) and pulmonary embolism (PE) are manifestations of the same disease, far from all patients develop PE. Our objective was to investigate risk-modifying factors. Setting, subjects and design. Between 1970 and 1982, 23 796 autopsies, representing 84% of all in-hospital deaths in the Malmo City population, were performed, using a standardized procedure. In a case-control study nested in a population-based cohort of patients with proximal DVT, the relationship between PE and body mass index (BMI), thoracic and abdominal subcutaneous (SC) fat thickness was evaluated. Results. Proximal DVT was found in 15%, of which 58% were women. Mean age in men was 4.5 years lower than in women (P &lt; 0.001). Fifty per cent of the patients had PE, half of which were fatal. Similar age- and gender distribution was found in cases and controls. Patients in the upper tertile of BMI, abdominal and thoracic SC fat thickness had, in comparison with mid-tertile, and independent of age, gender and death from cancer disease, an increased odds (95% CI) for PE of 1.24 (1.04-1.47) (P = 0.014), 1.28 (1.07-1.53) (P = 0.006) and 1.35 (1.13-1.61) (P = 0.001), respectively, whereas in patients of the lower tertiles, a negative association was found. Conclusions. We found no differences in age- and gender distribution between PE cases and controls. BMI and SC fat thickness were markers of disease progression from proximal DVT to PE. The highly significant and independent association indicates that SC obesity may be of greater importance in venous thromboembolism as compared with cardiovascular diseases related to visceral (abdominal) obesity with lipid- and glucose metabolic disturbances.},
  author       = {Ogren, M and Eriksson, H and Bergqvist, D and Sternby, Nils},
  issn         = {1365-2796},
  keyword      = {venous thromboembolism,embolism,pulmonary,obesity,epidemiology,adipose tissue,deep vein thrombosis},
  language     = {eng},
  number       = {2},
  pages        = {166--171},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Journal of Internal Medicine},
  title        = {Subcutaneous fat accumulation and BMI associated with risk for pulmonary embolism in patients with proximal deep vein thrombosis: a population study based on 23,796 consecutive autopsies},
  url          = {http://dx.doi.org/10.1111/j.1365-2796.2005.01517.x},
  volume       = {258},
  year         = {2005},
}