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Men who were overweight or had obesity as adolescents faced increased VTE risk as adults

Thu, 07/30/2020 - 08:55
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Men who were overweight or had obesity as adolescents have a substantial risk increase for developing venous thromboembolism (VTE) later in life compared with those who were not overweight or had obesity when they were adolescents, according to research headed by Sahlgrenska Academy at the University of Gothenburg in Sweden.

The study, ‘Obesity in young adulthood tied to later venous thromboembolism’, published in the Journal of Internal Medicine, sought to determine the association between body mass index (BMI) in young men at enlistment for military service and later risk of VTE, using a long‐term follow‐up of a large population of men from the Swedish Military Service Conscription Register.

In total, the study included 1,639 838 men, 79.8% were normal weight (BMI18.5<25), 9.9% were overweight (BMI25<30) and 2.2% had obesity (BMI≥30). Some 17,805 cases of first VTE events were recorded, for 860 individuals, a first DVT and PE were diagnosed on the same date. The event rate for VTE per 100 000 years was 73.7 in men with BMI30<35 at enlistment and 112.1 in men with BMI≥ 35 at enlistment, compared with 32.8 in men with BMI18.5<20 at enlistment. The men with obesity were younger than lean men at the time of diagnosis: 39.3 years in men with BMI≥35 at enlistment compared with 47.7 years in men with BMI18.5<20 at enlistment.

The cumulative incidence of VTE after 40 years’ follow‐up was 5.1% in men with BMI30<35 at enlistment and 8.4% in men with BMI≥35 at enlistment, compared with 1.8% in men with BMI18.5<20 kg. There was a gradual increase in cumulative incidence of VTE with increasing BMI, starting already at normal BMI levels (p<0.0001). A BMI30<35 was associated with a HR of 2.93 for VTE, HR for BMI≥35 was 4.95 for VTE compared with men with BMI18.5<20.

“The underlying mechanisms for this association remain to be elucidated,” the researchers concluded. “A clinical implication of our findings is that overweight and obesity in young adulthood is an important risk factor for later development of VTE later in life. Given the current global obesity epidemic, this will lead to great suffering and large costs for society. Action should be taken to reduce overweight and obesity early in life.”

This study was supported by grants from the Swedish state under an agreement between the Swedish government and the County Councils Concerning Economic Support of Research and Education of Doctors, the Swedish Heart and Lung Foundation, the Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences and the Swedish Research Council.

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