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High preoperative serum leptin level is an independent risk factor for deep vein thrombosis after total knee arthroplasty in osteoarthritis patients: A prospective and cross-sectional study.

Abstract It suggests that a high leptin level may increase the risk of venous thromboembolism (VTE) in animal studies. However, clinical studies in this field are still largely unexplored. Our objective was to evaluate the relationship between the preoperative serum leptin levels and postoperative VTE incidence in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) at our institute.We conducted a prospective and cross-sectional study in these OA patients from March 2014 to March 2016. Preoperative leptin levels were analyzed by Luminex assays. VTE was assessed preoperatively and on postoperative day 5 and 7. The potential risk factors for VTE were also documented.We enrolled 203 OA patients. No PE was detected and DVT was diagnosed in 34 patients postoperatively. There were significant differences between the median leptin levels in DVT group and non-DVT group [25.13 ng/mL (interquartile range, 14.51-44.31) vs 18.71 ng/mL (8.26-28.99), P = .007]. The relative risk of DVT significantly increased with natural logarithm (ln) leptin (per SD increase) (OR 2.37, 95% confidence interval (95% CI), 1.29-4.33, P = .005). Multivariate analyses adjusted for potential confounders showed ln leptin (per SD increase) was significantly associated with the relative risk of DVT (OR 2.17, 95% CI, 1.01-4.64, P = .046). When patients were subdivided into tertiles according to their leptin values, the OR for DVT increased with increasing tertiles of serum leptin (OR 1.03, 95% CI, 1.01-1.06, P for trend = .023).In the present study, our results indicate that a high preoperative leptin level may be an independent risk factor for postoperative DVT.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29794796
OWN - NLM
STAT- MEDLINE
DCOM- 20180604
LR  - 20180604
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 21
DP  - 2018 May
TI  - High preoperative serum leptin level is an independent risk factor for deep vein 
      thrombosis after total knee arthroplasty in osteoarthritis patients: A
      prospective and cross-sectional study.
PG  - e10884
LID - 10.1097/MD.0000000000010884 [doi]
AB  - It suggests that a high leptin level may increase the risk of venous
      thromboembolism (VTE) in animal studies. However, clinical studies in this field 
      are still largely unexplored. Our objective was to evaluate the relationship
      between the preoperative serum leptin levels and postoperative VTE incidence in
      osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) at our
      institute.We conducted a prospective and cross-sectional study in these OA
      patients from March 2014 to March 2016. Preoperative leptin levels were analyzed 
      by Luminex assays. VTE was assessed preoperatively and on postoperative day 5 and
      7. The potential risk factors for VTE were also documented.We enrolled 203 OA
      patients. No PE was detected and DVT was diagnosed in 34 patients
      postoperatively. There were significant differences between the median leptin
      levels in DVT group and non-DVT group [25.13 ng/mL (interquartile range,
      14.51-44.31) vs 18.71 ng/mL (8.26-28.99), P = .007]. The relative risk of DVT
      significantly increased with natural logarithm (ln) leptin (per SD increase) (OR 
      2.37, 95% confidence interval (95% CI), 1.29-4.33, P = .005). Multivariate
      analyses adjusted for potential confounders showed ln leptin (per SD increase)
      was significantly associated with the relative risk of DVT (OR 2.17, 95% CI,
      1.01-4.64, P = .046). When patients were subdivided into tertiles according to
      their leptin values, the OR for DVT increased with increasing tertiles of serum
      leptin (OR 1.03, 95% CI, 1.01-1.06, P for trend = .023).In the present study, our
      results indicate that a high preoperative leptin level may be an independent risk
      factor for postoperative DVT.
FAU - Lu, Wanli
AU  - Lu W
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
AD  - Laboratory for Bone and Joint Diseases, Model Animal Research Center, Nanjing
      University, Nanjing, Jiangsu, People's Republic of China.
FAU - Zhou, Sheng
AU  - Zhou S
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
AD  - Laboratory for Bone and Joint Diseases, Model Animal Research Center, Nanjing
      University, Nanjing, Jiangsu, People's Republic of China.
FAU - Xue, Long
AU  - Xue L
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
FAU - Dai, Bingyang
AU  - Dai B
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
FAU - Qiao, Liang
AU  - Qiao L
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
FAU - Chen, Dongyang
AU  - Chen D
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
FAU - Xu, Zhihong
AU  - Xu Z
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
FAU - Yao, Yao
AU  - Yao Y
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
FAU - Teng, Huajian
AU  - Teng H
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
AD  - Laboratory for Bone and Joint Diseases, Model Animal Research Center, Nanjing
      University, Nanjing, Jiangsu, People's Republic of China.
FAU - Jiang, Qing
AU  - Jiang Q
AD  - Sports Medicine & Adult Reconstructive Surgery, Drum Tower Hospital, School of
      Medicine.
AD  - Laboratory for Bone and Joint Diseases, Model Animal Research Center, Nanjing
      University, Nanjing, Jiangsu, People's Republic of China.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Leptin)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Arthroplasty, Replacement, Knee/*adverse effects
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Leptin/*blood
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis, Knee/*surgery
MH  - Postoperative Complications/epidemiology
MH  - Preoperative Period
MH  - Prospective Studies
MH  - Risk Factors
MH  - Ultrasonography, Doppler, Duplex/methods
MH  - Venous Thromboembolism/diagnostic imaging/epidemiology/metabolism
MH  - Venous Thrombosis/complications/diagnostic imaging/etiology/*metabolism
EDAT- 2018/05/26 06:00
MHDA- 2018/06/05 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [entrez]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/06/05 06:00 [medline]
AID - 10.1097/MD.0000000000010884 [doi]
AID - 00005792-201805250-00072 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(21):e10884. doi: 10.1097/MD.0000000000010884.