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


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 (<P10) (OR=2.1-3.6)(p<0.05) and mainly of sVCAM-1 (>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.


CONCLUSIONS
Although the exact mechanisms linking abnormal lipid and sVCAM-1 concentrations to VTE await clarification, both seem to be independently associated.
González-Ordóñez
Angel José
AJ
Department of Hematology, Hospital San Agustin, 33400, Avilés, Spain. jagonzalez@medynet.com
Fernández-Carreira
José-Manuel
JM
Fernández-Alvarez
Carmen Rosa
CR
Venta Obaya
Rafael
R
Macías-Robles
Marìa Dolores
MD
González-Franco
Alvaro
A
Arias Garcìa
Maria Ana
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011655:Pulmonary Embolism / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D012995:Solubility; D013923:Thromboembolism / Q000097:blood / Q000453:epidemiology*; D014280:Triglycerides / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*; D020246:Venous Thrombosis / Q000097:blood / Q000453:epidemiology
D008055:Lipids; D014280:Triglycerides; D019010:Vascular Cell Adhesion Molecule-1; D002784:Cholesterol