Interrelation of hyperhomocysteinemia and inherited risk factors for venous thromboembolism. Results from the E.D.I.TH. study: a hospital-based case-control study.
BACKGROUND
Moderate hyperhomocysteinemia and factor V Leiden mutation are among the most prevalent risk factors for venous thromboembolism (VTE). The hypothesis of an interaction between those risks has been raised and conflicting results were reported.


METHODS
We designed a hospital-based case-control study to test the interaction between Factor V Leiden and fasting serum total homocysteine (tHcy). We have also analysed the G20210A prothrombin gene variant. This study enrolled 904 hospitalised patients who had an objectively proven deep vein thrombosis and/or pulmonary embolism as well as 904 hospitalised control patients matched for gender, age and major acquired risk factor for VTE.


RESULTS
Our data did not detect any multiplicative interaction between hyperhomocysteinemia (>15 mumol/L) and factor V Leiden mutation or G20210A prothrombin gene variant. Odds ratios (95% CI) were 4.0 (1.5-11) and 6.0 (1.3-27) for the combined effect of hyperhomocysteinemia with either factor V Leiden mutation or G20210A prothrombin gene variant, respectively.


CONCLUSIONS
Current data provide further knowledge in relationship between hyperhomocysteinemia and inherited risk factors, such as factor V Leiden mutation and G20210A prothrombin gene variant. As those risk factors are not so rare among Caucasians, a better estimate of the risk related to double exposure might help to optimise venous thromboembolism prevention.
Oger
Emmanuel
E
G.E.T.B.O. EA-3878 (Groupe d'Etude de la Thrombose de Bretagne Occidentale), Department of Internal Medicine and Chest Diseases, Brest University Hospital, 29609 Brest Cedex, France. emmanuel.oger@chu-brest.fr
Lacut
Karine
K
Le Gal
Grégoire
G
Couturaud
Francis
F
Abalain
Jean-Hervé
JH
Mercier
Bernard
B
Mottier
Dominique
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D016022:Case-Control Studies; D017931:DNA Primers / Q000235:genetics; D005165:Factor V / Q000235:genetics; D005260:Female; D005602:France; D014644:Genetic Variation; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D011247:Pregnancy; D011516:Prothrombin / Q000235:genetics; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood / Q000209:etiology* / Q000235:genetics*; D020246:Venous Thrombosis / Q000097:blood / Q000209:etiology* / Q000235:genetics*
D017931:DNA Primers; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin