Association of medical comorbidities in obese subjects diagnosed with heparin-induced thrombocytopenia

Matthew Darok; Alexander Daly; Vonn Walter; Conrad Krawiec

doi:10.1177/20503121241247471

Association of medical comorbidities in obese subjects diagnosed with heparin-induced thrombocytopenia

SAGE Open Med. 2024 May 6:12:20503121241247471. doi: 10.1177/20503121241247471. eCollection 2024.

Authors

Matthew Darok¹, Alexander Daly², Vonn Walter³, Conrad Krawiec⁴

Affiliations

¹ Pediatrics, Department of Pediatrics, Penn State Hershey Children's Hospital, Hershey, PA, USA.
² Hospital Pediatrics, Department of Pediatrics, Penn State Hershey Children's Hospital, Hershey, PA, USA.
³ Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.
⁴ Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children's Hospital, Hershey, PA, USA.

Abstract

Objectives: Heparin-induced thrombocytopenia can occur in obese subjects. The medical comorbidities associated with obesity may contribute to the pathogenesis of this disease. It is unknown, however, which specific medical comorbidities and if higher odds of thrombosis are present in obese heparin-induced thrombocytopenia patients. We sought to determine whether obese heparin-induced thrombocytopenia subjects had higher odds of both comorbidities and thrombosis, hypothesizing that this patient population would have higher odds of both these conditions.

Methods: This was a multi-center retrospective study utilizing TriNetX^©, an electronic health record database, in subjects aged 18-99 years diagnosed with heparin-induced thrombocytopenia. The cohort was divided into two groups (1) non-obese (body mass index < 30 kg/m²) and (2) obese (body mass index ⩾ 30 kg/m²). We evaluated patient characteristics, diagnostic, laboratory, medication, and procedure codes.

Results: A total of 1583 subjects (696 (44.0%) non-obese and 887 (56.0%) obese) were included. Obese subjects had higher odds of diabetes with complications (OR = 1.73, 95% CI = 1.35-2.22, p < 0.001) and without complications (OR = 1.81, 95% CI = 1.47-2.22, p < 0.001). This association was still present after correcting for demographic and clinical factors. There were no increased odds of thrombosis observed in the obesity group.

Conclusions: Our study found that obese heparin-induced thrombocytopenia subjects had higher odds of having a diabetes mellitus comorbidity, but did not have higher odds of thrombosis. Given obesity is considered a hypercoagulable state, further study may be needed to understand why obese subjects diagnosed with heparin-induced thrombocytopenia do not have higher rates of thrombosis.

Keywords: Obesity; comorbidity; heparin; thrombosis.