Risk factors for venous thromboembolism in pre- and postmenopausal women

被引:36
作者
Bergendal, Annica [1 ]
Bremme, Katarina [2 ,3 ]
Hedenmalm, Karin [6 ,7 ]
Larfars, Gerd [5 ]
Odeberg, Jacob [3 ,4 ]
Persson, Ingemar [1 ,6 ]
Sundstrom, Anders [1 ]
Kieler, Helle [1 ]
机构
[1] Karolinska Inst, Dept Med Solna, Ctr Pharmacoepidemiol, SE-17176 Stockholm, Sweden
[2] Karolinska Inst, Div Obstet & Gynecol, Dept Womens & Childrens Hlth, SE-17176 Stockholm, Sweden
[3] Univ Hosp, Stockholm, Sweden
[4] Karolinska Inst, Dept Med Solna, Ctr Hematol, SE-17176 Stockholm, Sweden
[5] Sodersjukhuset Karolinska Inst, Sect Internal Med, Dept Clin Sci & Educ, Stockholm, Sweden
[6] Med Prod Agcy, Uppsala, Sweden
[7] Uppsala Univ, Dept Med Sci, Uppsala, Sweden
关键词
Venous thromboembolism; Menopause; Risk factors; Estrogens; Epidemiology; DEEP-VEIN THROMBOSIS; ORAL-CONTRACEPTIVE USE; PULMONARY-EMBOLISM; REPLACEMENT; THERAPY; SMOKING; INCREASES; ETIOLOGY; DISEASE; OBESITY;
D O I
10.1016/j.thromres.2012.05.024
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Introduction: Hemostasis in women is affected by changes of estrogen levels. The role of endogenous estrogens on risk of venous thromboembolism (VTE) remains unclear. The aim of this study was to investigate the importance of acquired and genetic risk factors for VTE in pre- and postmenopausal women. Method: In a nationwide case-control study we included as cases 1470 women, 18 to 64 years of age with a first time VTE. The 1590 controls were randomly selected and matched by age to the cases. Information on risk factors was obtained by interviews and DNA-analyses. We used unconditional logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Results: The ORs were generally of similar magnitude in pre- and postmenopausal women. The highest risk was for the combination of surgery and cast (adjusted OR 54.12, 95% CI 16.62-176.19) in postmenopausal women. The adjusted OR for use of menopausal hormone therapy was 3.73 (95% CI 1.86-7.50) in premenopausal and 2.22 (95% CI 1.54-3.19) in postmenopausal women. Overweight was linked to an increased risk and exercise to a decreased risk, regardless of menopausal status. Conclusion: Menopausal status had only minor influence on the risk levels. Acquired transient risk factors conveyed the highest risks for VTE. (c) 2012 Elsevier Ltd. All rights reserved.
引用
收藏
页码:596 / 601
页数:6
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