OC 54.2 - Visceral Adipose Tissue is associated with an increased risk of venous thromboembolism independent of body mass index

Background: Increased body mass index (BMI) has been demonstrated to be associated with an increased risk of venous thrombosis. However, recent data has highlighted that other measures of adiposity, namely visceral adipose tissue (VAT) volume, may be a better marker of cardiometabolic risk. However, the relationship between VAT and VTE risk has not previously been investigated.

Aims: The aim of this study is to utilise the UK Biobank (UKB) to investigate the relationship between VAT volume and VTE risk and explore whether VAT volume can be used as a predictive marker for VTE risk, independently of BMI and other covariates.

Methods: We performed a cohort study utilising MRI imaging data from the UKB. The association between VTE incidence and VAT measured by MRI imaging from 39,144 UKB patients was analysed by ridge regression accounting for covariates of age, sex, BMI, smoking, diabetes, cancer status, blood type, C-reactive protein concentration, and the presence of genetic thrombophilia defined by the presence of the following SNPs; rs6025_T (Factor V Leiden mutation), rs2066865_A (Fibrinogen gamma gene), rs4253416_T (Factor XI gene), rs2519093_T (ABO haplotype), rs8176645_A (ABO haplotype), and rs1799963_A (Prothrombin gene mutation).

Results: VAT volume, as measured by MRI was demonstrated to be independently associated with an increased risk of VTE [OR =1.49 (95%CI:1.299-1.682) per dm^3, p = 4.5 × 10^-5]. Moreover, we observed a significant effect of VAT volume on VTE risk in both those who were overweight [OR BMI_Overweight&VAT_High = 1.44(95%CI:1.17-1.7), p = 0.007, OR BMI_Overweight&VAT_Medium = 1.3(95%CI:1.06-1.54), p = 0.03] and obese [OR BMI_Obese&VAT_High = 2.57(95%CI:2.32-2.8), p = 2× 10^-14]. Notably, the strongest effect of increased VAT was observed in those with obesity.

Conclusion(s): These data demonstrate for the first time that VAT volume is associated with an increased risk of VTE, and importantly has a stronger association with VTE risk as compared to BMI.