Association of PAI-1 gene 4G/5G polymorphism with the risk of deep vein thrombosis in lower extremities

SUN Jingcun; ZHANG Hongliang

doi:10.3969/j.issn.1002-7386.2025.08.008

Abstract：Objective To investigate the association between the PAI-1 gene 4G/5G polymorphism and the risk of deep vein thrombosis(DTV)in the lower extremities.Methods A total of 100 patients with DTV after total hip arthroplasty(THA),total knee arthroplasty(TKA)or hip fracture surgery(HFS)from June 2022 to June 2023 were selected as the experimental group.During the same period,100 patients without postoperative DTV were selected as the control group.Thrombelastogram,coagulation function,blood glucose,triacylglycerol,cholesterol and 4G/5G polymorphism distribution were compared between the two groups.The influencing factors for DTV were analyzed by Logistic regression.Results There were no significant differences in the thromboelastogram indicators between groups(P＞0.05).There were no significant differences in the prothrombin time/international normalized ratio(PT-INR),thrombin time(TT)and antithrombin Ⅲ(ATⅢ)between groups(P＞0.05).Significant differences were detected in the prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),plasminogen activator inhibitor-1(PAI-1),fibrin degradation products(FDP),and d-dimer(D-D)between groups.Among them,significantly longer PT and APTT,higher FIB,PAI-1,FDP and D-D were seen in the experimental group than the control group(P＜0.05).There were no significant differences in the total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)between groups(P＞0.05).Glycated hemoglobin(HbA1c)and platelet aggregation rate were significantly higher in the experimental group than the control group(P＜0.05).The distribution of the PAI-1 gene 4G/4G genotype(60.00％vs 35.00％)and 4G allele(72.00％vs 58.00％)was significantly higher in the experimental group than the control group(P＜0.05).The statistically significant indicators in the univariate logistic analysis were included in the multivariate logistic regression analysis model.PAI-1 4G/4G polymorphism(OR=2.130,P=0.013),allelic frequency of 4G/4G(OR=2.399,P=0.016),platelet aggregation rate(OR=2.125,P=0.006),HbA1c(OR=2.474,P=0.018),and D-D(OR=2.328,P=0.000)were risk factors for postoperative DVT in the lower extremities.Conclusion 4G/5G polymorphism of PAI-1 gene is closely associated with the risk of DVT in the lower extremities.The 4G/4G genotype and 4G allele are especially key factors to predict the risk of DTV,providing reference values for the mechanism research of DTV and the clinical prevention and treatment of DTV.