Insulin resistance and risk of venous thromboembolism: results of a population-based cohort study

J Thromb Haemost. 2012 Jun;10(6):1012-8. doi: 10.1111/j.1538-7836.2012.04707.x.


Background: Obesity is an established risk factor for venous thromboembolism (VTE), but it is uncertain how this is mediated. Insulin resistance has a central role in the pathophysiology of the metabolic effects of obesity.

Objective: We aimed to investigate whether insulin resistance is a risk factor for VTE.

Methods: For this analysis we used the PREVEND prospective community-based observational cohort study. Insulin resistance was measured as HOMA-IR (homeostasis model assessment of insulin resistance) and fasting insulin. VTE was assessed using databases of the national registries of hospital discharge diagnoses, death certificates and the regional anticoagulation clinic.

Results: Out of 7393 subjects, 114 developed VTE during a median follow-up of 10.5 years. High HOMA-IR was associated with increased risk of VTE after adjustment for traditional cardiovascular risk factors, CRP and markers of endothelial dysfunction (hazard ratio [HR], 1.38; 95% confidence interval [95% CI], 1.09-1.75; P=0.007). When body mass index (BMI) was added to the model, BMI was a strong risk predictor for VTE (HR, 1.53; 95% CI, 1.24-1.88; P<0.001) whereas HOMA-IR no longer showed such an association (HR, 1.11; 95% CI, 0.85-1.43; P=0.45). Results were similar for fasting insulin.

Conclusion: Our population-based cohort study shows an increased risk of VTE in subjects with increasing insulin resistance but not independently of BMI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Body Mass Index
  • Chi-Square Distribution
  • Female
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Netherlands / epidemiology
  • Obesity / blood
  • Obesity / epidemiology*
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Venous Thromboembolism / blood
  • Venous Thromboembolism / epidemiology*


  • Biomarkers
  • Insulin