Journal de médecine vasculaire et de chirurgie

Abstrait

The Association between Venous Thromboembolism and Lipid Profile in a Tunisian Population

Ben Brik A, Denguir H, Chahed H, Ben Romdhan M, Rzig N, Zruigui M, Ferchichi S, Fodha A and Miled A

Background and objectives: Lipids and lipoproteins modulate the expression and/or the function of thrombotic, fibrinolytic and rheological factors among patients with cardiovascular disease. Many studies have suggested a link between risk factors of venous thromboembolism (VTE) and dyslipidemia but results are heterogeneous. We sought to identify if dyslipidemia is a risk factor of VTE disease. Patients and methods: We have developed an hospital-based case-control study which was conducted in 32 patients with VTE and 33 age- and gender-matched healthy controls. We were proceeding to compare the lipid profile of the two groups after analysing the total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), Lipoprotein Lp(a), Apo-A1, Apo-B and Apo-E. Patients who have cancer and whose taken statins or fibrates are excluded. Results: The two groups have the same demographic characteristics but there were more diabetics, arterial hypertension and obese in the VTE group than the control group respectively (Diabetic: 37% vs. 18%, hypertension: 68.6% vs. 15.2% and (body mass index) BMI ≥30 Kg/m2: 43.8% vs. 18.2%). The mean value of the total cholesterol (TC), the LDL-C, Lipoprotein Lp (a), and Apo-B were statistically higher in the VTE group compared to control group respectively ; TC (4.942 ± 1.409 vs. 4.362 ± 0.872 mmol/L,P=0.049), LDL-C (3.114 ± 1.100 vs. 2.602 ± 0.695 mmol/L, P=0.001), Lp (a) (0.205 ± 0.115 vs. 0.0819 ± 0.0479 g/l, P <10-3), Apo-B (1.333 ± 0.253 vs. 0.8006 ± 0.238 g/l, P<10-3), but there was no statistical significant difference was observed between the two groups in the value of Triglycerides and Apo E respectively (1.710 ± 0.816 vs. 1.366 ± 0.636 mmol/L, P=0.62), (0.102 ± 0.070 vs. 0.0810 ± 0.153 g/l, P=0.48). However, the mean value of HDL-C and Apo-A1 were statically lower in the VTE group; HDL-C (1.048 ± 0.237 vs. 1.473 ± 0.334 mmol/L, P<0.001) and Apo-A1 (1.010 ± 0.2437 vs. 1.414 ± 0.2911 g/l, P<10-3). Furthermore, enhanced HDL-C ≤0.906 mmol/L was diagnosed in 21 patients (65.6%) in the VTE group versus 4 patients (12.1%) in the control group (P<0.001), so it was also independently associated with a risk of VTE. Conclusion: The present study shows a significant association between the occurrence of venous thromboembolism and lower levels of HDL-C and ApoA1 and higher levels of LDL-C, Apo-B and Lp(a), but, there were no effect of Triglycerides and ApoE. Nevertheless, these results must be confirmed with a large population study to prove an eventual independent factor for VTE and dyslipidemia