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Association and Pathways between Dietary Manganese Intake and Incident Venous Thromboembolism
Yu Huang1, Yanjun Zhang1, Sisi Yang1
1Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China.
Background:
The association between dietary manganese (Mn) intake and the risk of venous thromboembolism (VTE) remains unknown. We aimed to investigate the associations of dietary Mn intake with incident VTE, and the underlying mediating roles of obesity markers (body mass index [BMI] and waist circumference), hemorheological parameters (red cell distribution width [RDW], platelet count [PLT], and mean platelet volume [MPV]), and inflammatory biomarkers (C-reactive protein [CRP] and white blood cell count [WBC]) in this association.
Methods:
A total of 202,507 adults from the UK Biobank with complete dietary data and without VTE at baseline were included. Dietary information was collected by the online 24-hour diet recall questionnaires (Oxford WebQ). The primary outcome was incident VTE, a composite of incident deep vein thrombosis (DVT) and pulmonary embolism (PE).
Results:
During a median follow-up of 11.6 years, 4,750 participants developed incident VTE. Overall, there were significantly inverse relationships of dietary Mn intake with incident VTE (per 1 mg/day increment; adjusted hazard ratio [HR]: 0.92; 95% confidence interval [CI]: 0.90-0.95), incident DVT (per 1 mg/day increment; adjusted HR: 0.93; 95% CI: 0. 90-0.96), and incident PE (per 1 mg/day increment; adjusted HR: 0.91; 95% CI: 0.88-0.95). BMI, waist circumference, RDW, CRP, and WBC significantly mediated the association between dietary Mn intake and incident VTE, with the mediated proportions of 36.0, 36.5, 4.2, 4.3, and 1.6%, respectively. However, MPV and PLT did not significantly mediate the association.
Conclusion:
Our study shows that dietary Mn intake was inversely associated with incident VTE. The inverse association was mainly mediated by obesity, followed by inflammatory biomarkers and RDW. Our findings are just hypothesis-generating, and further confirmation of our findings in more studies is essential.
Insights
Higher dietary manganese intake is linked to a lower risk of venous thromboembolism (VTE). Obesity and inflammation markers partially explain this protective association, suggesting potential dietary interventions for VTE prevention.
Area of Science:
- Nutritional Epidemiology
- Cardiovascular Health
- Thrombosis Research
Background:
- The relationship between dietary manganese (Mn) and venous thromboembolism (VTE) risk is not well-established.
- Investigating potential mediators like obesity, hemorheology, and inflammation is crucial for understanding this association.
Purpose of the Study:
- To examine the association between dietary manganese intake and the risk of incident VTE.
- To explore the mediating roles of obesity markers, hemorheological parameters, and inflammatory biomarkers in the Mn-VTE relationship.
Main Methods:
- Utilized UK Biobank data from 202,507 adults without baseline VTE.
- Dietary intake assessed via online 24-hour recall (Oxford WebQ).
- Incident VTE (deep vein thrombosis and pulmonary embolism) was the primary outcome, with a median follow-up of 11.6 years.
Main Results:
- Dietary manganese intake showed a significant inverse association with incident VTE, DVT, and PE.
- Obesity markers (BMI, waist circumference) substantially mediated this association (36.0%, 36.5%).
- Inflammatory biomarkers (CRP, WBC) and RDW also significantly mediated the association, while MPV and PLT did not.
Conclusions:
- Dietary manganese intake is inversely associated with incident VTE.
- Obesity, inflammatory biomarkers, and RDW are key mediators in this relationship.
- Findings are hypothesis-generating and require further validation in diverse populations.
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