Male-specific risk of first and recurrent venous thrombosis: a phylogenetic analysis of the Y chromosome

J Thromb Haemost. 2016 Oct;14(10):1971-1977. doi: 10.1111/jth.13437. Epub 2016 Oct 12.

Abstract

Essentials Men have an unexplained higher risk of a first and recurrent venous thrombosis (VT) than women. We studied the role of the major European Y chromosome haplogroups in first and recurrent VT. In contrast to a study on coronary artery disease, haplogroup I was not linked to VT risk. Haplogroup E-carriers may have an increased risk of recurrent VT, but a larger study is needed.

Summary: Background The risk of venous thrombosis (VT) recurrence is higher in men than in women. When reproductive risk factors are excluded, this sex difference is also apparent for a first VT. The current explanations for this difference are insufficient. Objectives To study the association between chromosome Y haplogroups and the risks of a first and recurrent VT. Methods Y chromosomes of 3742 men (1729 patients; 2013 controls) from the MEGA case-control study were tracked into haplogroups according to the phylogenetic tree. We calculated the risk of a first VT by comparing the major haplogroups with the most frequent haplogroup. For recurrence risk, 1645 patients were followed for a mean of 5 years, during which 350 developed a recurrence (21%; MEGA follow-up study). We calculated recurrence rates for the major haplogroups, and compared groups by calculating hazard ratios. Results We observed 13 haplogroups, of which R1b was the most frequent (59%). The major haplogroups were not associated with a first VT, with odds ratios ranging from 1.01 to 1.15. Haplogroup E carriers had the highest recurrence rate (53.5 per 1000 person-years, 95% confidence interval [CI] 33.3-86.1), whereas haplogroup R1a carriers had the lowest recurrence rate (24.3 per 1000 person-years, 95% CI 12.6-46.6). As compared with haplogroup R1b carriers, both haplogroups were not significantly associated with recurrence risk. Conclusions In contrast to a study on coronary artery disease, our results do not show a clear predisposing effect of Y haplogroups on first and recurrent VT risk in men. It is therefore unlikely that Y variation can explain the sex difference in VT risk.

Keywords: Y chromosome; genetic variation; recurrence; risk factors; venous thrombosis.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Chromosome Mapping
  • Chromosomes, Human, Y / genetics*
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / genetics
  • Female
  • Follow-Up Studies
  • Genetic Variation
  • Haplotypes
  • Heterozygote
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Odds Ratio
  • Phylogeny
  • Polymorphism, Single Nucleotide
  • Proportional Hazards Models
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / genetics
  • Recurrence
  • Risk Factors
  • Sex Factors*
  • Venous Thrombosis / blood*
  • White People / genetics