肥胖的荷尔蒙避孕药使用者的静脉血栓栓塞:一个大型的国家数据库研究研究
Divyaswathi Citla-Sridhar1, Madhvi Rajpurkar2, Lakshmi Srivaths3
1Division of Hematology Oncology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
Research and practice in thrombosis and haemostasis
|November 28, 2025
概括
使用某些激素疗法 (HT) 的肥胖女性面临更高的静脉血栓塞栓症 (VTE) 风险. 这包括以乙雌激醇 (EE) 结合利沃诺格斯特勒,诺雷丁龙或诺格斯蒂的疗法,强调肥胖是HT处方的关键因素.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 心血管健康 心血管健康
- 药物监督 药物监督 药物监督
背景情况:
- 激素疗法 (HT) 广泛用于生殖年龄女性的各种疾病.
- 肥胖是已知的静脉血栓塞栓症 (VTE) 的风险因素,但其与HT的相互作用需要进一步调查.
- 在肥胖与非肥胖个体中了解与不同HT配方相关的VTE风险对于患者安全至关重要.
研究的目的:
- 为了评估肥胖与VTE风险之间的关联,在10-44岁的女性中处方HT.
- 在肥胖和非肥胖人群中比较不同类型的HT的VTE发病率.
- 为了确定特定的HT配方,可能会在肥胖个体中构成更高的VTE风险.
主要方法:
- 使用TriNETX数据的回顾性队列研究,来自56家美国医院的8100万名患者 (2000-2022).
- 根据体重指数 (BMI) 和HT处方对女性进行分层.
- 根据ICD代码和抗凝剂处方确定VTE发生率,并将倾向性得分与混者控制相匹配.
主要成果:
- 分析了400多万名女性;34%的女性肥胖.
- 肥胖的HT用户与非肥胖用户 (0.51%) 相比,表现出更高的VTE发病率 (0.99%).
- 与levonorgestrel,norethindrone或norgestimate一起含有乙烯乙醇 (EE) 的特定HT显示,与非肥胖用户相比,肥胖用户的VTE率显著增加.
结论:
- 在使用某些HT的女性中,肥胖与VTE的风险增加显著相关,特别是那些含有特定孕激素的EE.
- 这些发现强调了在处方HT时考虑患者的BMI的重要性.
- 风险分层对VTE应纳入肥胖状况,特别是对于配方如EE与levonorgestrel,norethindrone或norgestimate.
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