The concentrations of soluble vascular cell adhesion molecule-1 and lipids are independently associated with venous thromboembolism.

نویسندگان

  • Angel José González-Ordóñez
  • José-Manuel Fernández-Carreira
  • Carmen Rosa Fernández-Alvarez
  • Rafael Venta Obaya
  • Marìa Dolores Macías-Robles
  • Alvaro González-Franco
  • Maria Ana Arias Garcìa
چکیده

BACKGROUND AND OBJECTIVES Venous thromboembolism (VTE) involves inflammation and a relation with dyslipidemia which remains controversial. The vascular cell adhesion molecule-1 (VCAM-1) is a ligand expressed by activated endothelium (and recruits leukocytes) whose soluble form (sVCAM-1) increases in atherosclerosis, severe hypertriglyceridemia or deep vein thrombosis (DVT) in acute phase. We analyzed the association between VTE (> 6 months after), sVCAM-1 and lipid concentrations. DESIGN AND METHODS Case-control study involving 126 consecutive patients (aged 25-80 years, 49% males) and 125 controls of similar age and gender. RESULTS The patients had a more unfavorable lipid profile than controls [higher triglycerides (p<0.001), LDLc/HDLc ratio (p<0.01) or total cholesterol (TC) (p=0.07)] and higher sVCAM-1 concentration (p<0.01) even adjusting for arterial diseases. VTE was associated with extreme values of TC, LDL-c, triglycerides (>P90) and HDL-c (P90) (OR=4.2)(p<0.0001). The sVCAM-1 values were age-related (r=0.26, p<0.001) but independent of lipid levels. Hazards ratios from five-fold to ten-fold appeared when combining the sVCAM-1 top quartile (>970 ng/mL) with TC >250 mg/dL or HDL-c <45 mg/dL (p<0.01) irrespective of thrombophilic status. Recurrent or severe VTE cases (pulmonary embolism or proximal DVT vs. distal DVT) showed higher sVCAM-1 values (p<0.05). All the associations weakened among females. In stepwise logistic regression, obesity (p<0.001), sVCAM-1 (p<0.001) and LDL-c (p=0.004) in men and sVCAM-1 (p=0.02) and triglycerides (p=0.04) in women retained their independent association. INTERPRETATION AND CONCLUSIONS Although the exact mechanisms linking abnormal lipid and sVCAM-1 concentrations to VTE await clarification, both seem to be independently associated.

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عنوان ژورنال:
  • Haematologica

دوره 88 9  شماره 

صفحات  -

تاریخ انتشار 2003