{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T04:21:47Z","timestamp":1793161307108,"version":"4.5.0"},"reference-count":48,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>\n            Background\u2003Obesity is a well-established risk factor for venous thromboembolism (VTE). However, data on the proportion of incident VTEs attributed to overweight and obesity in the general population are limited.<\/jats:p><jats:p>\n            Objective\u2003To investigate the population attributable fraction (PAF) of VTE due to overweight and obesity in a population-based cohort with repeated measurements of body mass index (BMI).<\/jats:p><jats:p>\n            Methods\u2003Participants from the fourth to seventh surveys of the Troms\u00f8 Study (enrolment: 1994\u20132016) were followed through 2020, and all incident VTEs were recorded. In total, 36,341 unique participants were included, and BMI measurements were updated for those attending more than one survey. BMI was categorized as &lt;25\u2009kg\/m2, 25\u201330\u2009kg\/m2 (overweight), and \u226530\u2009kg\/m2 (obesity). Time-varying Cox regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). The PAF was estimated based on age- and sex-adjusted HRs and the prevalence of BMI categories in VTE cases.<\/jats:p><jats:p>\n            Results\u2003At baseline, the prevalence of overweight and obesity was 37.9 and 13.8%, respectively. During a median follow-up of 13.9 years, 1,051 VTEs occurred. The age- and sex-adjusted HRs of VTE were 1.40 (95% CI: 1.21\u20131.61) for overweight and 1.86 (95% CI: 1.58\u20132.20) for obesity compared with subjects with BMI &lt;25\u2009kg\/m2. The PAF of VTE due to overweight and obesity was 24.6% (95% CI: 16.6\u201332.9), with 12.9% (95% CI: 6.6\u201319.0) being attributed to overweight and 11.7% (95% CI: 8.5\u201314.9) to obesity. Similar PAFs were obtained in analyses stratified by sex and VTE subtypes (provoked\/unprovoked events, deep vein thrombosis, pulmonary embolism).<\/jats:p><jats:p>\n            Conclusion\u2003Our findings indicate that almost 25% of all VTE events can be attributed to overweight and obesity in a general population from Norway.<\/jats:p>","DOI":"10.1055\/s-0043-1772212","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T22:55:31Z","timestamp":1691448931000},"page":"239-249","source":"Crossref","is-referenced-by-count":40,"title":["The Risk of Incident Venous Thromboembolism Attributed to Overweight and Obesity: The Troms\u00f8 Study"],"prefix":"10.1055","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3203-3686","authenticated-orcid":false,"given":"Tobias","family":"Frischmuth","sequence":"additional","affiliation":[{"name":"Thrombosis Research Group, Department of Clinical Medicine, UiT\u2014The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Division of Internal Medicine, Thrombosis Research Center, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte G.","family":"T\u00f8ndel","sequence":"additional","affiliation":[{"name":"Thrombosis Research Group, Department of Clinical Medicine, UiT\u2014The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid K.","family":"Br\u00e6kkan","sequence":"additional","affiliation":[{"name":"Thrombosis Research Group, Department of Clinical Medicine, UiT\u2014The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Division of Internal Medicine, Thrombosis Research Center, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John-Bjarne","family":"Hansen","sequence":"additional","affiliation":[{"name":"Thrombosis Research Group, Department of Clinical Medicine, UiT\u2014The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Division of Internal Medicine, Thrombosis Research Center, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e2nia M.","family":"Morelli","sequence":"additional","affiliation":[{"name":"Thrombosis Research Group, Department of Clinical Medicine, UiT\u2014The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Division of Internal Medicine, Thrombosis Research Center, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1093\/aje\/kwi309","article-title":"Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism","volume":"162","author":"R J Glynn","year":"2005","journal-title":"Am J Epidemiol"},{"issue":"11","key":"ref2","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1161\/ATVBAHA.114.304488","article-title":"Thrombosis: a major contributor to global disease burden","volume":"34","author":"G E Raskob","year":"2014","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(20)32658-1","article-title":"Venous thromboembolism","volume":"398","author":"F Khan","year":"2021","journal-title":"Lancet"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1111\/j.1538-7836.2006.01795.x","article-title":"Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolism treated with warfarin for 6 weeks or 6 months","volume":"4","author":"S Schulman","year":"2006","journal-title":"J Thromb Haemost"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.blre.2014.07.003","article-title":"The post-PE syndrome: a new concept for chronic complications of pulmonary embolism","volume":"28","author":"F A Klok","year":"2014","journal-title":"Blood Rev"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1111\/jth.13411","article-title":"Venous thromboembolism and subsequent permanent work-related disability","volume":"14","author":"S K Braekkan","year":"2016","journal-title":"J Thromb Haemost"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"e1003770","DOI":"10.1371\/journal.pmed.1003770","article-title":"Risk of a permanent work-related disability pension after incident venous thromboembolism in Denmark: a population-based cohort study","volume":"18","author":"H J\u00f8rgensen","year":"2021","journal-title":"PLoS Med"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1161\/CIRCULATIONAHA.115.016960","article-title":"Trends in modifiable risk factors are associated with declining incidence of hospitalized and nonhospitalized acute coronary heart disease in a population","volume":"133","author":"J Mannsverk","year":"2016","journal-title":"Circulation"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1161\/STROKEAHA.116.014377","article-title":"Declining incidence of ischemic stroke: what is the impact of changing risk factors? The Troms\u00f8 Study 1995 to 2012","volume":"48","author":"A M Vangen-L\u00f8nne","year":"2017","journal-title":"Stroke"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s10654-017-0238-y","article-title":"Time trends in incidence rates of venous thromboembolism in a large cohort recruited from the general population","volume":"32","author":"N Arshad","year":"2017","journal-title":"Eur J Epidemiol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.thromres.2019.02.009","article-title":"A changing landscape: temporal trends in incidence and characteristics of patients hospitalized with venous thromboembolism 2006-2015","volume":"176","author":"A M M\u00fcnster","year":"2019","journal-title":"Thromb Res"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1160\/TH16-07-0509","article-title":"Reasons for the persistent incidence of venous 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thromboembolism: the Troms\u00f8 study","volume":"11","author":"L D Horvei","year":"2016","journal-title":"PLoS One"},{"issue":"12","key":"ref17","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1038\/s41366-020-00674-5","article-title":"Weight change over 9 years and subsequent risk of venous thromboembolism in the ARIC cohort","volume":"44","author":"S A French","year":"2020","journal-title":"Int J Obes"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"e001643","DOI":"10.1161\/CIRCGENETICS.116.001643","article-title":"Genetic analysis of venous thromboembolism in UK biobank identifies the ZFPM2 locus and implicates obesity as a causal risk factor","volume":"10","author":"D Klarin","year":"2017","journal-title":"Circ Cardiovasc Genet"},{"issue":"07","key":"ref19","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1007\/s00439-017-1811-x","article-title":"Assessing the causal relationship between obesity and venous thromboembolism through a Mendelian Randomization study","volume":"136","author":"S Lindstr\u00f6m","year":"2017","journal-title":"Hum Genet"},{"issue":"34","key":"ref20","doi-asserted-by":"crossref","first-page":"3388","DOI":"10.1093\/eurheartj\/ehab454","article-title":"Association between adiposity and cardiovascular outcomes: an umbrella review and meta-analysis of observational and Mendelian randomization studies","volume":"42","author":"M S Kim","year":"2021","journal-title":"Eur Heart J"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"15","DOI":"10.2105\/AJPH.88.1.15","article-title":"Use and misuse of population attributable fractions","volume":"88","author":"B Rockhill","year":"1998","journal-title":"Am J Public Health"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"k757","DOI":"10.1136\/bmj.k757","article-title":"Population attributable fraction","volume":"360","author":"M A Mansournia","year":"2018","journal-title":"BMJ"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1111\/jth.15168","article-title":"Overall and abdominal obesity in relation to venous thromboembolism","volume":"19","author":"S Yuan","year":"2021","journal-title":"J Thromb Haemost"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1093\/oxfordjournals.aje.a010013","article-title":"Underestimation of risk associations due to regression dilution in long-term follow-up of prospective studies","volume":"150","author":"R Clarke","year":"1999","journal-title":"Am J Epidemiol"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1093\/ije\/dyr049","article-title":"Cohort profile: the Tromso Study","volume":"41","author":"B K Jacobsen","year":"2012","journal-title":"Int J Epidemiol"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/1403494812469851","article-title":"The sixth survey of the Tromso Study (Tromso 6) in 2007-08: collaborative research in the interface between clinical medicine and epidemiology: study objectives, design, data collection procedures, and attendance in a multipurpose population-based health survey","volume":"41","author":"A E Eggen","year":"2013","journal-title":"Scand J Public Health"},{"issue":"11","key":"ref27","doi-asserted-by":"crossref","first-page":"e038465","DOI":"10.1136\/bmjopen-2020-038465","article-title":"Prevalence of general and abdominal obesity in 2015-2016 and 8-year longitudinal weight and waist circumference changes in adults and elderly: the Troms\u00f8 Study","volume":"10","author":"O L\u00f8vsletten","year":"2020","journal-title":"BMJ 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The Troms\u00f8 Study","volume":"5","author":"B K Jacobsen","year":"2015","journal-title":"BMJ Open"},{"key":"ref30","volume-title":"WHO European Regional Obesity Report 2022","author":"World Health Organization","year":"2022"},{"issue":"9159","key":"ref31","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1016\/S0140-6736(98)10266-0","article-title":"Venous thrombosis: a multicausal disease","volume":"353","author":"F R Rosendaal","year":"1999","journal-title":"Lancet"},{"issue":"07","key":"ref32","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1111\/jth.13336","article-title":"Categorization of patients as having provoked or unprovoked venous thromboembolism: guidance from the SSC of ISTH","volume":"14","author":"C Kearon","year":"2016","journal-title":"J Thromb Haemost"},{"issue":"11","key":"ref33","doi-asserted-by":"crossref","first-page":"839","DOI":"10.7326\/0003-4819-145-11-200612050-00141","article-title":"National Institutes of Health State-of-the-Science conference statement: tobacco use: prevention, cessation, and control","volume":"145","author":"NIH State-of-the-Science Panel","year":"2006","journal-title":"Ann Intern Med"},{"issue":"12","key":"ref34","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1161\/CIR.0b013e318260a20b","article-title":"Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association","volume":"126","author":"D Mozaffarian","year":"2012","journal-title":"Circulation"},{"issue":"23","key":"ref35","doi-asserted-by":"crossref","first-page":"e019395","DOI":"10.1161\/JAHA.120.019395","article-title":"Exploring opportunities for primary prevention of unprovoked venous thromboembolism: ready for prime time?","volume":"9","author":"A R Folsom","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"07","key":"ref36","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1111\/obr.12551","article-title":"Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation","volume":"18","author":"G A Bray","year":"2017","journal-title":"Obes Rev"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.mcna.2017.08.012","article-title":"Maintenance of lost weight and long-term management of obesity","volume":"102","author":"K D Hall","year":"2018","journal-title":"Med Clin North Am"},{"issue":"03","key":"ref38","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.jvs.2010.04.023","article-title":"Impact of obesity on venous hemodynamics of the lower limbs","volume":"52","author":"T Willenberg","year":"2010","journal-title":"J Vasc Surg"},{"issue":"02","key":"ref39","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/nri2921","article-title":"Adipokines in inflammation and metabolic disease","volume":"11","author":"N Ouchi","year":"2011","journal-title":"Nat Rev Immunol"},{"issue":"05","key":"ref40","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/j.1467-789X.2009.00593.x","article-title":"Role of adipose tissue in haemostasis, coagulation and fibrinolysis","volume":"10","author":"D R Faber","year":"2009","journal-title":"Obes Rev"},{"issue":"02","key":"ref41","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1046\/j.1467-789X.2002.00056.x","article-title":"Obesity, haemostasis and the fibrinolytic system","volume":"3","author":"I Mertens","year":"2002","journal-title":"Obes Rev"},{"issue":"11","key":"ref42","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1038\/sj.ijo.0802778","article-title":"Obesity and impaired fibrinolysis: role of adipose production of plasminogen activator inhibitor-1","volume":"28","author":"T Skurk","year":"2004","journal-title":"Int J Obes Relat Metab Disord"},{"issue":"12","key":"ref43","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1111\/jth.12742","article-title":"Inflammation markers and incident venous thromboembolism: the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort","volume":"12","author":"N C Olson","year":"2014","journal-title":"J Thromb Haemost"},{"issue":"08","key":"ref44","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1111\/jth.13369","article-title":"C-reactive protein, obesity, and the risk of arterial and venous thrombosis","volume":"14","author":"L D Horvei","year":"2016","journal-title":"J Thromb Haemost"},{"issue":"07","key":"ref45","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1111\/jth.15701","article-title":"Elevated plasma levels of plasminogen activator inhibitor-1 are associated with risk of future incident venous thromboembolism","volume":"20","author":"T Frischmuth","year":"2022","journal-title":"J Thromb Haemost"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"653655","DOI":"10.3389\/fcvm.2021.653655","article-title":"A serpin with a finger in many PAIs: PAI-1's central function in thromboinflammation and cardiovascular disease","volume":"8","author":"G B Morrow","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"622473","DOI":"10.3389\/fcvm.2020.622473","article-title":"Targeting PAI-1 in cardiovascular disease: structural insights into PAI-1 functionality and inhibition","volume":"7","author":"M Sillen","year":"2020","journal-title":"Front Cardiovasc Med"},{"issue":"01","key":"ref48","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1161\/ATVBAHA.109.188920","article-title":"Anthropometric measures of obesity and risk of venous thromboembolism: the Tromso study","volume":"30","author":"K H Borch","year":"2010","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"11","key":"ref49","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s10654-014-9950-z","article-title":"Obesity measures and risk of venous thromboembolism and myocardial infarction","volume":"29","author":"L D Horvei","year":"2014","journal-title":"Eur J Epidemiol"}],"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1772212.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:17:52Z","timestamp":1730801872000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1772212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,7]]},"references-count":48,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2024,2,23]]},"published-print":{"date-parts":[[2024,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1772212","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,7]]}}}