Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control study
Abstract Background Previous studies suggested an elevated risk of venous thromboembolism (VTE) among patients with type 2 diabetes mellitus (T2DM), with a possible sex difference. The impact of glycemic control on the risk of VTE is unclear. Our objective was to analyze the association between glyc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-021-01432-1 |
| _version_ | 1818979404541329408 |
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| author | Sarah H. R. Charlier Christian Meier Susan S. Jick Christoph R. Meier Claudia Becker |
| author_facet | Sarah H. R. Charlier Christian Meier Susan S. Jick Christoph R. Meier Claudia Becker |
| author_sort | Sarah H. R. Charlier |
| collection | DOAJ |
| description | Abstract Background Previous studies suggested an elevated risk of venous thromboembolism (VTE) among patients with type 2 diabetes mellitus (T2DM), with a possible sex difference. The impact of glycemic control on the risk of VTE is unclear. Our objective was to analyze the association between glycemic control and the risk of unprovoked (idiopathic) VTE in men and women with T2DM. Methods We conducted a nested case–control analysis (1:4 matching) within a cohort of patients with incident T2DM between 1995 and 2019 using data from the CPRD GOLD. We excluded patients with known risk factors for VTE prior to onset of DM. Cases were T2DM patients with an unprovoked treated VTE. The exposure of interest was glycemic control measured as HbA1c levels. We conducted conditional logistic regression analyses adjusted for several confounders. Results We identified 2′653 VTE cases and 10′612 controls (53.1% females). We found no association between the HbA1c level and the risk of VTE in our analyses. However, when the most recent HbA1c value was recorded within 90 days before the index date, women with HbA1c levels > 7.0% had a 36–55% increased relative risk of VTE when compared to women with HbA1c > 6.5–7.0%. Conclusions Our study raises the possibility that female T2DM patients with HbA1c levels > 7% may have a slightly higher risk for unprovoked VTE compared to women with HbA1c levels > 6.5–7.0%. This increase may not be causal and may reflect differences in life style or other characteristics. We observed no effect of glycemic control on the risk of VTE in men. |
| first_indexed | 2024-12-20T16:59:00Z |
| format | Article |
| id | doaj.art-85d03e829cf54984adac992a4b90412e |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-20T16:59:00Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-85d03e829cf54984adac992a4b90412e2022-12-21T19:32:38ZengBMCCardiovascular Diabetology1475-28402022-01-0121111110.1186/s12933-021-01432-1Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control studySarah H. R. Charlier0Christian Meier1Susan S. Jick2Christoph R. Meier3Claudia Becker4Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of BaselDivision of Endocrinology, Diabetes & Metabolism, University Hospital BaselBoston Collaborative Drug Surveillance ProgramBasel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of BaselBasel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of BaselAbstract Background Previous studies suggested an elevated risk of venous thromboembolism (VTE) among patients with type 2 diabetes mellitus (T2DM), with a possible sex difference. The impact of glycemic control on the risk of VTE is unclear. Our objective was to analyze the association between glycemic control and the risk of unprovoked (idiopathic) VTE in men and women with T2DM. Methods We conducted a nested case–control analysis (1:4 matching) within a cohort of patients with incident T2DM between 1995 and 2019 using data from the CPRD GOLD. We excluded patients with known risk factors for VTE prior to onset of DM. Cases were T2DM patients with an unprovoked treated VTE. The exposure of interest was glycemic control measured as HbA1c levels. We conducted conditional logistic regression analyses adjusted for several confounders. Results We identified 2′653 VTE cases and 10′612 controls (53.1% females). We found no association between the HbA1c level and the risk of VTE in our analyses. However, when the most recent HbA1c value was recorded within 90 days before the index date, women with HbA1c levels > 7.0% had a 36–55% increased relative risk of VTE when compared to women with HbA1c > 6.5–7.0%. Conclusions Our study raises the possibility that female T2DM patients with HbA1c levels > 7% may have a slightly higher risk for unprovoked VTE compared to women with HbA1c levels > 6.5–7.0%. This increase may not be causal and may reflect differences in life style or other characteristics. We observed no effect of glycemic control on the risk of VTE in men.https://doi.org/10.1186/s12933-021-01432-1Diabetes mellitus type 2Venous thromboembolismVTEGlycemic controlHbA1cSex |
| spellingShingle | Sarah H. R. Charlier Christian Meier Susan S. Jick Christoph R. Meier Claudia Becker Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control study Cardiovascular Diabetology Diabetes mellitus type 2 Venous thromboembolism VTE Glycemic control HbA1c Sex |
| title | Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control study |
| title_full | Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control study |
| title_fullStr | Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control study |
| title_full_unstemmed | Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control study |
| title_short | Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control study |
| title_sort | association between glycemic control and risk of venous thromboembolism in diabetic patients a nested case control study |
| topic | Diabetes mellitus type 2 Venous thromboembolism VTE Glycemic control HbA1c Sex |
| url | https://doi.org/10.1186/s12933-021-01432-1 |
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