Influence of lipid metabolism disorders on venous thrombosis risk Translated title: Uticaj poremećaja lipidnog metabolizma na rizik od venske tromboze

Abstract

Background: To investigate the influence of lipid metabolism disorders on the risk of deep vein thrombosis.

Methods: A total of 200 subjects participated in the study, 100 of whom experienced DVT with or without PTE, and 100 healthy subjects representing the control group. We classified patients and controls in terms of serum concentrations of chylomicrons, LDL, IDL, VLDL, and HDL particles, as those with or without hyperlipoproteinemia and in terms of serum Lp (a) lipoprotein levels, as those with hyperLp (a) lipoproteinemia (serum Lp (a) values >0.3 g/L) and those without hyperLp (a) lipoproteinemia (serum Lp (a) values <0.3 g/L). Based on the modified and supplemented Fredrickson classification, participants with verified existences of hyperlipoproteinemia were classified into subgroups based on the type of hyperlipoproteinemia. Unconditional logistic regression was used to calculate ORs with 95% CIS as a measure of the relative risks for venous thrombosis in participants with hyperlipoproteinemia compared with those without hyperlipoproteinemia. The analysis was adjusted for all potential confounders (age, sex, obesity) related to the functionality of the lipid metabolism, and at the same time, may have an impact on the risk of venous thrombosis.

Results: The results of the comparison of the mean values of individual lipid status parameters between the patient group and the control group clearly indicate higher concentrations of total cholesterol (5.93 mmol/L vs. 5.52 mmol/L), total triglycerides (1.58 mmol/L vs. 1.50 mmol/L), and LDL-cholesterol (3.83 mmol/L vs. 3.44 mmol/L) in the patient group relative to the control group, with a statistically significant difference observed only in the case of LDL-cholesterol concentrations. We have found that type IIa hyperlipoproteinemia is associated with a nearly double increased risk for deep vein thrombosis (OR 1.99; Cl 1.01-3.90), while type IIb, IV, or hyperLp (a) lipoproteinemia did not influence the risk (OR 1.22; 95% Cl 0.79-1.84; OR 0.89; 95% Cl 0.52-1.54 OR 1.85; 95% CI 0.84-4.04).

Conclusions: Hypercholesterolemia doubles the risk of deep vein thrombosis development.

Translated abstract

Uvod: Cilj je bio da se istraži uticaj poremećaja metabolizma lipida na rizik od razvoja tromboze dubokih vena.

Metode: U istraživanju je učestvovalo ukupno 200 ispitanika, od kojih je 100 doživelo DVT sa ili bez PTE i 100 zdravih ispitanika koji su predstavljali kontrolnu grupu. Pacijente i kontrolnu grupu klasifikovali smo prema serumskim koncentracijama hilomikrona, LDL, IDL, VLDL i HDL čestica, na one sa ili bez hiperlipoproteinemije i prema nivou Lp (a) lipoproteina u serumu, na one sa hiperLp (a) lipoproteinemijom (serumske vrednosti Lp (a) > 0,3 g/L) i one bez hiperLp (a) lipoproteinemije (vrednosti Lp (a) u serumu < 0,3 g/L). Na osnovu modifikovane i dopunjene Fredriksonove klasifikacije ispitanici sa dokazanim postojanjem hiperlipoproteinemije razvrstani su u podgrupe prema tipu hiperlipoproteinemije. Ne kondicionalna logistička regresija je korištena za izračunavanje OR-a sa 95% CI kao mere relativnog rizika od venske tromboze kod ispitanika sa hiperlipoproteinemijom u poređenju sa onima bez hiperlipoproteinemije. Analiza je prilagođena za sve potencijalne "confoundere" (uzrast, pol, gojaznost) koji se odnose na funkcionalnost metabolizma lipida, a istovremeno mogu imati uticaj na rizik od nastanka venske tromboze.

Rezultati: Rezultati poređenja srednjih vrednosti pojedinačnih parametara lipidnog statusa između grupe pacijenata i kontrolne grupe jasno ukazuju na veće koncentracije ukupnog holesterola (5,93 mmol/L naspram 5,52 mmol/L), ukupnih triglicerida (1,58 mmol/L naspram 1,50 mmol/L) i LDL-holesterola (3,83 mmol/L naspram 3,44 mmol/L) u grupi pacijenata u odnosu na kontrolnu grupu, sa statistički značajnom razlikom uočenom samo u slučaju koncentracije LDL-holesterola. Otkriveno je da je hiperlipoproteinemija tipa IIa povezana sa gotovo dvostruko većim rizikom od duboke venske tromboze (OR 1,99; Cl 1,01-3, 90), dok lipoproteinemija tipa IIb, IV ili hyperLp (a) nije uticala na rizik (OR 1,22; 95% Cl 0,79-1,84; OR 0,89; 95% Cl 0,52-1,54 ILI 1,85; 95% CI 0,84-4,04).

Zaključak: Hiperholesterolemija udvostručuje rizik od razvoja tromboze dubokih vena.