Venous thrombosis is associated with hyperglycemia at diagnosis: a case-control study

Patients with (undiagnosed) diabetes mellitus, impaired glucose tolerance or stress-induced hyperglycemia may be at greater risk for venous thrombosis and present with relative hyperglycemia during the thrombotic event.

To assess whether venous thrombosis is associated with hyperglycemia at diagnosis.

We performed a case-control study, derived from a cohort of consecutive patients referred for suspected deep vein thrombosis. Cases were patients with confirmed symptomatic venous thrombosis of the lower extremity. Controls were randomly selected in a 1 : 2 ratio from individuals in whom this diagnosis was excluded. We measured plasma glucose levels upon presentation to the hospital.

In total, 188 patients with thrombosis and 370 controls were studied. The glucose cut-off levels for the first to fourth quartiles were as follows: first quartile, < 5.3 mmol L(-1); second quartile, 5.3-5.7 mmol L(-1); third quartile, 5.7-6.6 mmol L(-1); and fourth quartile, >or= 6.6 mmol L(-1). When adjusted for body mass index, a known history of diabetes mellitus, age, sex, ethnicity and whether known risk factors for deep vein thrombosis were present, the odds ratios for deep vein thrombosis in the second, third and fourth quartiles of glucose levels as compared with the first quartile were 1.59 [95% confidence interval (CI) 0.89-2.85], 2.04 (95% CI 1.15-3.62) and 2.21 (95% CI 1.20-4.05), respectively; P for trend = 0.001.

Increased glucose levels measured at presentation were associated with venous thrombosis. Experimental evidence supports a potential causal role for hyperglycemia in this process. As this is the first report on the association between (stress) hyperglycemia and venous thrombosis, confirmation in other studies is required.