Association between body mass index, waist circumference, and relative fat mass with the risk of first unprovoked venous thromboembolism

Nutr Metab Cardiovasc Dis. 2021 Oct 28;31(11):3122-3130. doi: 10.1016/j.numecd.2021.07.018. Epub 2021 Jul 30.

Abstract

Background and aims: Obesity defined by body mass index (BMI) is independently associated with venous thromboembolism (VTE). Abdominal obesity, defined by waist circumference, is a predictor of cardiovascular events. Recently, relative fat mass (RFM) was proposed as a marker of cardiovascular risk. We assessed the role of three different measures of obesity to predict unprovoked VTE in a longitudinal study.

Methods and results: Moli-sani is a prospective cohort study carried out in the general population of the Molise region, Italy. A total of 23,538 individuals (48% men, age 55.4 years) enrolled between 2005 and 2010 were eligible. Patients on anticoagulant treatment were excluded. BMI ≥30 kg/m2 defined obesity, waist circumference >102 cm for men or 88 cm for women defined abdominal obesity, tertiles of RFM were compared. The long-term incidence of first unprovoked VTE during follow-up was assessed. Overall, 29.6% individuals were obese and 44.2% had abdominal obesity. A total of 66 first unprovoked VTE events were diagnosed during a median follow-up of 8.2 years. After multivariable Cox regression analysis, the risk of unprovoked VTE was significantly higher in obese participants (HR 1.89, 95% CI 1.16-3.07) than in participants with BMI <30; in subjects with abdominal obesity than with normal waist circumference (HR 2.19, 1.26-3.81); and in subjects with third vs first RFM tertile index (HR 2.46, 1.15-5.28). The areas under the curves for the models including the three obesity indexes were comparable.

Conclusions: Three indexes of obesity based on BMI, waist circumference or RFM similarly predict first occurrence of unprovoked VTE.

Keywords: Body mass index; Obesity; Relative fat mass; Venous thromboembolism; Waist circumference.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity*
  • Adult
  • Aged
  • Body Mass Index*
  • Female
  • Humans
  • Incidence
  • Italy / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity, Abdominal / diagnosis
  • Obesity, Abdominal / epidemiology*
  • Obesity, Abdominal / physiopathology
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Venous Thromboembolism / diagnosis
  • Venous Thromboembolism / epidemiology*
  • Waist Circumference*