Thromb Haemost 2022; 122(09): 1549-1557
DOI: 10.1055/s-0042-1744377
Stroke, Systemic or Venous Thromboembolism

Association of Combined Lifestyle and Polygenetic Risk with Incidence of Venous Thromboembolism: A Large Population-Based Cohort Study

Yu-Jie Zhang
1   Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
,
Zhi-Hao Li
1   Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
,
Dong Shen
1   Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
,
Pei-Dong Zhang
1   Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
,
Shi-Hui Fu
2   Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
,
Yao Yao
3   China Center for Health Development Studies, Peking University, Beijing, China
,
Jing-Xin Wang
4   Department of Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
,
Pei-Liang Chen
1   Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
,
Pei Zhang
5   School of Life Science, Beijing Institute of Technology, Beijing, China
,
Xi-Ru Zhang
1   Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
,
Chen Mao
1   Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
› Author Affiliations
Funding This work was supported by the National Natural Science Foundation of China (81973109 and 82173588 to C.M., 82001476 to Y-.J.Z.), China Postdoctoral Science Foundation (2020M682816 and 2021T140298 to Y-.J.Z.), Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2019 to C.M.), the National Key Research and Development Program of China (2018YFC2000400 to C.M.), the Construction of High-level University of Guangdong (G820332010, G618339167, and G618339164 to C.M.), Guangdong Basic and Applied Basic Research Foundation (2021A1515011629T (C.M.), and Guangzhou Science and Technology Project (202002030255 to C.M.).

Abstract

As one of the fatal complications, venous thromboembolism (VTE) is associated with increased mortality. However, the combined effects of adopting multiple healthy lifestyles have not been firmly demonstrated. This study was to evaluate the association of combined healthy lifestyles and genetic risk factors with VTE and to investigate their interaction. A prospective cohort study from UK Biobank with a total of 442,963 men and women aged between 38 to 73 years were recruited from 2006 to 2010 and followed up through 2017 or 2018. A polygenic risk score was constructed and a weighted healthy lifestyle score, including no current smoking, regular physical exercises, healthy diet, and healthy body mass index, was categorized. During a median follow-up 9.0 years (3,912,396 person-years), there were 6,736 (172 per 100,000 person-years) incident VTE cases recorded. Among the participants with an unfavorable lifestyle, 1.80% developed VTE, versus 1.03% of the participants with a favorable lifestyle (hazard ratio [HR]: 1.58; 95% confidence interval [CI]: 1.48–1.68). Of the participants with high genetic risk, 2.42% developed VTE, versus 0.97% of the participants with low genetic risk (HR: 2.60; 95% CI: 2.39–2.81). Moreover, of the participants with high genetic risk and unfavorable lifestyle, 2.90% developed VTE, versus 0.66% of the participants with low genetic risk and favorable lifestyle (HR: 4.09; 95% CI: 3.48–4.79). No significant interaction between genetic risk and lifestyle factors was observed (p for interaction = 0.727). An unfavorable lifestyle was associated with a substantially higher risk of VTE, regardless of the genetic risk strata.

Author Contributions

Y-.J.Z. contributed to the conception of the study design and drafted the manuscript. P-.D.Z. and P.Z. helped with the interpretation of data and the statistical analysis. Z-.H.L., D.S., S-.H.F., Y.Y., J-.X.W., P-.L.C., and X-.R.Z. helped with the revision of the manuscript. C.M. participated in the design of the study and was the guarantor of the work. All authors read and approved the final manuscript.


Data Availability

The UK Biobank data are available from the UK Biobank on request (www.ukbiobank.ac.uk/).


Supplementary Material



Publication History

Received: 12 January 2022

Accepted: 24 January 2022

Article published online:
27 May 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany