Background The association between dietary manganese (Mn) intake and the risk of venous thromboembolism (VTE) remains unknown. We aimed to investigate the associations of dietary Mn intake with incident VTE, and the underlying mediating roles of obesity markers (body mass index [BMI] and waist circumference), hemorheological parameters (red cell distribution width [RDW], platelet count [PLT], and mean platelet volume [MPV]), and inflammatory biomarkers (C-reactive protein [CRP] and white blood cell count [WBC]) in this association.

Methods A total of 202,507 adults from the UK Biobank with complete dietary data and without VTE at baseline were included. Dietary information was collected by the online 24-hour diet recall questionnaires (Oxford WebQ). The primary outcome was incident VTE, a composite of incident deep vein thrombosis (DVT) and pulmonary embolism (PE).

Results During a median follow-up of 11.6 years, 4,750 participants developed incident VTE. Overall, there were significantly inverse relationships of dietary Mn intake with incident VTE (per 1 mg/day increment; adjusted hazard ratio [HR]: 0.92; 95% confidence interval [CI]: 0.90–0.95), incident DVT (per 1 mg/day increment; adjusted HR: 0.93; 95% CI: 0. 90–0.96), and incident PE (per 1 mg/day increment; adjusted HR: 0.91; 95% CI: 0.88–0.95). BMI, waist circumference, RDW, CRP, and WBC significantly mediated the association between dietary Mn intake and incident VTE, with the mediated proportions of 36.0, 36.5, 4.2, 4.3, and 1.6%, respectively. However, MPV and PLT did not significantly mediate the association.

Conclusion Our study shows that dietary Mn intake was inversely associated with incident VTE. The inverse association was mainly mediated by obesity, followed by inflammatory biomarkers and RDW. Our findings are just hypothesis-generating, and further confirmation of our findings in more studies is essential.

背景 膳食锰 (Mn) 摄入量与静脉血栓栓塞 (VTE) 风险之间的关系仍不清楚。我们的目的是研究膳食锰摄入量与 VTE 发生的关系，以及肥胖标志物（体重指数 [BMI] 和腰围）、血液流变学参数（红细胞分布宽度 [RDW]、血小板计数 [PLT]）的潜在中介作用。 ，和平均血小板体积 [MPV]），以及炎症生物标志物（C 反应蛋白 [CRP] 和白细胞计数 [WBC]）。

方法 纳入来自英国生物银行的 202,507 名成年人，他们具有完整的饮食数据且基线时没有 VTE。饮食信息通过在线 24 小时饮食回忆问卷 (Oxford WebQ) 收集。主要结局是发生静脉血栓栓塞（VTE），即发生深静脉血栓（DVT）和肺栓塞（PE）的复合事件。

结果 在中位随访 11.6 年期间，4,750 名参与者发生了静脉血栓栓塞事件。总体而言，膳食锰摄入量与 VTE 发生率（每 1 mg/天增量；调整后风险比 [HR]：0.92；95% 置信区间 [CI]：0.90–0.95）、DVT 发生率（每 1 mg/天）呈显着负相关。 /天增量；调整后 HR：0.93；95% CI：0. 90–0.96) 和事件 PE（每 1 毫克/天增量；调整后 HR：0.91；95% CI：0.88–0.95）。BMI、腰围、RDW、CRP 和 WBC 显着介导膳食锰摄入量与 VTE 事件之间的关联，介导比例分别为 36.0%、36.5%、4.2%、4.3% 和 1.6%。然而，MPV 和 PLT 并没有显着介导这种关联。

结论 我们的研究表明，饮食中锰的摄入量与静脉血栓栓塞事件呈负相关。负相关主要由肥胖介导，其次是炎症生物标志物和 RDW。我们的研究结果只是假设，有必要在更多研究中进一步证实我们的研究结果。