VLDL subfractions and risk of future venous thromboembolism - The HUNT study.

BACKGROUND: In vitro studies have suggested prothrombotic properties of very low-density lipoproteins (VLDL). Whether differences in VLDL particle size and lipid composition is related to venous thromboembolism (VTE) risk has been scarcely investigated. We aimed to investigate the association between chylomicron and VLDL subfractions and the risk of incident VTE in a population-based cohort. METHODS: Participants (n=17,032) from the third survey of the Trøndelag Health Study (HUNT3, 2006-08) were followed through December 31, 2019, and all incident VTE events during follow-up were validated and recorded. Nuclear magnetic resonance (NMR) spectroscopy was used to measure chylomicron and VLDL subfractions (including particle size, concentration, and lipid composition) in serum collected at cohort baseline. Associations between VLDL subfractions and risk of VTE were assessed using Cox regression models, adjusted for age, sex, and body mass index. RESULTS: In total, 342 incident VTE cases occurred during a median follow-up of 12.0 years. No associations were found between VLDL particle size, VLDL concentration, VLDL lipid composition, total triglycerides, and VTE risk. All hazard ratios (HRs) per one standard deviation increase in VLDL metrics were within the range 0.87-1.16 and all 95% confidence intervals (CIs) included 1. Increasing quartiles of total VLDL particles (Q4 vs. Q1 HR: 1.12, 95% CI:0.80-1.56) and the proportion of larger VLDL particles (Q4 vs Q1: HR: 1.09, 95% CI: 0.81-1.45) were not associated with VTE risk. CONCLUSION: Total triglycerides and VLDL subfractions, including particle size, concentration, and lipid composition, were not associated with risk of incident VTE.