[1]范婷泳 袁丽.体重指数和中心性肥胖与复发性静脉血栓栓塞关系的meta分析[J].心血管病学进展,2022,(6):559.[doi:10.16806/j.cnki.issn.1004-3934.2022.06.019]
 FAN Tingyong YUAN Li.Body Mass Index and Central Obesity with Recurrent Venous Thromboembolism:a Meta-Analysis[J].Advances in Cardiovascular Diseases,2022,(6):559.[doi:10.16806/j.cnki.issn.1004-3934.2022.06.019]
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体重指数和中心性肥胖与复发性静脉血栓栓塞关系的meta分析()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年6期
页码:
559
栏目:
论著
出版日期:
2022-06-25

文章信息/Info

Title:
Body Mass Index and Central Obesity with Recurrent Venous Thromboembolism:a Meta-Analysis
作者:
范婷泳1 袁丽2
(1.四川大学华西医院老年医学中心干部医疗科/四川大学华西护理学院,四川 成都 610041;2.四川大学华西医院内分泌代谢科,四川 成都 610041)
Author(s):
FAN Tingyong1 YUAN Li2
(Department of The Center of Gerontology and Geriatrics,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu 610041, Sichuan,China;2.Department of Endocrinology&Metabolism,West China Hospital,Sichuan University,Chengdu 610041, Sichuan,China)
关键词:
超重一般性肥胖中心性肥胖复发性静脉血栓栓塞meta分析
Keywords:
OverweightGeneral obesityCentral obesityRecurrent venous thromboembolismMeta-analysis
DOI:
10.16806/j.cnki.issn.1004-3934.2022.06.019
摘要:
目的 通过meta分析明确超重、一般性肥胖和中心性肥胖与复发性静脉血栓栓塞(VTE)的关系。方法 系统检索PubMed、Embase、中国知网、和万方数据库,筛选超重、一般性肥胖以及中心性肥胖与复发性VTE关联的观察性研究,包括前瞻性与回顾性研究。采用Stata 12.0 软件对纳入数据进行统计分析,加权合并OR及其相应的95% CI。结果 本研究共纳入14篇文献。与正常体重相比,超重与复发性VTE无显著关联(OR=1.11,95% CI 0.96~1.28,P=0.154),中心性肥胖与复发性VTE无显著关联(OR=1.26,95% CI 0.86~1.86,P=0. 238 ),一般性肥胖与复发性VTE呈显著正相关(OR=1.49,95% CI 1.24~1.79,P<0.001)。亚组分析结果显示,一般性肥胖与复发性VTE风险在不同年龄、研究人群、样本量和研究设计亚组分析中均呈显著正相关。对9篇前瞻性研究结果汇总分析发现,一般性肥胖个体VTE复发风险增加了44%(OR=1.44,95% CI 1.02~2.04,P<0.001)。结论 一般性肥胖与复发性VTE呈显著正相关,对于VTE合并肥胖患者,建议通过减轻体重,有针对性地调整抗凝药物治疗方案,从而预防VTE的复发。此外,由于目前国内关于体重指数和中心性肥胖与VTE复发的相关研究鲜见,未来尚需要在中国人群中开展大样本以及高质量的前瞻性研究进行验证。
Abstract:
Objective To explore the relationship of overweight, general obesity (GO) and central obesity (CO) with the risk of recurrent venous thromboembolism (VTE). Methods We systematically searched PubMed, Embase, CNKI and Wanfang database to collect observational studies on the relationship of overweight, GO and CO with recurrent VTE, including prospective and retrospective studies. The statistical analysis was conducted by Stata 12.0 software. The OR and corresponding 95% CI were pooled. Results A total of 14 studies were included. Compared with normal weight, overweight was not significantly related to the risk of recurrent VTE (OR=1.11,95%CI 0.96~1.28,P=0.154), CO was not significantly related to the risk of recurrent VTE (OR=1.26,95% CI 0.86~1.86,P=0. 238 ),respectively, while GO was positively related to it ( OR=1.49, 95% CI 1.24~1.79, P<0.001). Furthermore, subgroup analysis results showed GO was positively related to recurrent VTE in subgroups of different age, study population, sample size and study design. Pooled results of 9 prospective studies showed GO increased the risk of recurrent VTE by 44% ( OR=1.44, 95% CI 1.02~2.04, P<0.001). Conclusion There was a significant positive relationship between GO and recurrent VTE. For patients with VTE complicated by obesity , the reduction of body weight and adjustment of anticoagulant plan should be recommended to prevent VTE recurrence. In addition, as few domestic study has explored the association of body mass index and CO with VTE recurrence, future large-sample and high-quality prospective studies in China should be conducted for validation

参考文献/References:

[1] Huang W,Goldberg RJ,Anderson FA,et al. Secular trends in occurrence of acute venous thromboembolism:the Worcester VTE study (1985-2009)[J]. Am J Med,2014,127(9):829-839.e5.[2] Stewart LK,Kline JA. Metabolic syndrome increases risk of venous thromboembolism recurrence after acute deep vein thrombosis[J]. Blood Adv,2020,4(1):127-135.[3] Prandoni P,Noventa F,Ghirarduzzi A,et al. The risk of recurrent venous thromboembolism after discontinuing anticoagulation in patients with acute proximal deep vein thrombosis or pulmonary embolism. A prospective cohort study in 1,626 patients[J]. Haematologica,2007,92(2):199-205.[4] Carrier M,Le Gal G,Wells PS,et al. Systematic review:case-fatality rates of recurrent venous thromboembolism and major bleeding events among patients treated for venous thromboembolism[J]. Ann Intern Med,2010,152(9):578-589.[5] Lauber S,Limacher A,Tritschler T,et al. Predictors and outcomes of recurrent venous thromboembolism in elderly patients[J]. Am J Med,2018,131(6):703.e7- 703.e16.[6] Cohen AT,Katholing A,Rietbrock S,et al. Epidemiology of first and recurrent venous thromboembolism in patients with active cancer. A population-based cohort study[J]. Thromb Haemost,2017,117(1):57-65.[7] Laczkovics C,Grafenhofer H,Kaider A,et al. Risk of recurrence after a first venous thromboembolic event in young women[J]. Haematologica,2007,92(9):1201-1207.[8] Eichinger S,Hron G,Bialonczyk C,et al. Overweight,obesity,and the risk of recurrent venous thromboembolism[J]. Arch Intern Med,2008,168(15):1678-1683.[9] 王星. 静脉血栓栓塞症复发危险因素的研究进展[J]. 实用心脑肺血管病杂志,2015,23(9):1-3.[10] García-Fuster MJ,Forner MJ,Fernández C,et al. Long-term prospective study of recurrent venous thromboembolism in patients younger than 50 years[J]. Pathophysiol Haemost Thromb,2005,34(1):6-12.[11] Mueller C,Limacher A,Mean M,et al. Obesity is not associated with recurrent venous thromboembolism in elderly patients:results from the prospective SWITCO65+ cohort study[J]. PLoS One,2017,12(9):e0184868.[12] Vuckovic BA,Cannegieter SC,van Hylckama Vlieg A,et al. Recurrent venous thrombosis related to overweight and obesity:results from the MEGA follow-up study[J]. J Thromb Haemost,2017,15(7):1430-1435.[13] Greenland S. Quantitative methods in the review of epidemiologic literature[J]. Epidemiol Rev,1987,9:1-30.[14] Asim M,Al-Thani H,El-Menyar A. Recurrent deep vein thrombosis after the first venous thromboembolism event:a single-institution experience[J]. Med Sci Monit,2017,23:2391-2399.[15] Ay C,Tengler T,Vormittag R,et al. Venous thromboemlism—a manifestation of the metabolic syndrome[J]. Haematologica,2007,92(3):374-380.[16] Franco Moreno AI,García Navarro MJ,Ortiz Sánchez J,et al. A risk score for prediction of recurrence in patients with unprovoked s thromboevenous thromboembolism (DAMOVES)[J]. Eur J Intern Med,2016,29:59-64.[17] Linnemann B,Zgouras D,Schindewolf M,et al. Impact of sex and traditional cardiovascular risk factors on the risk of recurrent venous thromboembolism:results from the German MAISTHRO Registry[J]. Blood Coagul Fibrinolysis,2008,19(2):159-165.[18] Olié V,Zhu T,Martinez I,et al. Sex-specific risk factors for recurrent venous thromboembolism[J]. Thromb Res,2012,130(1):16-20.[19] Rodger MA,Kahn SR,Wells PS,et al. Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy[J]. CMAJ,2008,179(5):417-426.[20] Romualdi E,Squizzato A,Ageno W. Abdominal obesity and the risk of recurrent deep vein thrombosis[J]. Thromb Res,2007,119(6):687-690.[21] Stewart LK,Kline JA. Metabolic syndrome increases risk of venous thromboembolism recurrence after acute pulmonary embolism[J]. Ann Am Thorac Soc,2020,17(7):821-828.[22] 李靖,李星,赵琼,等. 静脉血栓栓塞症复发预测模型的研究进展[J]. 中华护理杂志,2020,55(11):1723-1727.[23] Stein PD,Beemath A,Olson RE. Obesity as a risk factor in venous thromboembolism[J]. Am J Med,2005,118(9):978-980.[24] Darvall KA,Sam RC,Silverman SH,et al. Obesity and thrombosis[J]. Eur J Vasc Endovasc Surg,2007,33(2):223-233.[25] Beijers HJ,Ferreira I,Spronk HM,et al. Body composition as determinant of thrombin generation in plasma:the Hoorn study[J]. Arterioscler Thromb Vasc Biol,2010,30(12):2639-2647.

更新日期/Last Update: 2022-08-05