Franco R F, Reitsma P H, Lourenço D, Maffei F H, Morelli V, Tavella M H, Araújo A G, Piccinato C E, Zago M A
Department of Clinical Medicine, FMRP, USP and Blood Centre of Ribeirão Preto, FUNDHERP, Botucatu, Brazil.
Thromb Haemost. 1999 May;81(5):676-9.
A mutation in the factor XIII gene (FXIII Val34Leu) gene was recently reported to confer protection against myocardial infarction, but its relationship with venous thrombosis is unknown. In addition, a mutation in the 5'-untranslated region of the FXII gene (46 C->T) was identified which is associated with low plasma levels of the protein. Its prevalence in patients with venous thrombosis is also unknown. We investigated the frequency of the FXIII Val34Leu and FXII 46 C->T mutations in 189 patients with deep venous thrombosis and in 187 age-, gender- and race-matched controls. FXIII Val34Leu was detected in 38.6% of the patients and in 41.2% of the controls. Interestingly, homozygosity for the FXIII mutation was found in 1.6% of the patients and in 9.6% of the controls, yielding an odds ratio (OR) for venous thrombosis of 0.16 (95% CI: 0.05-0.5). The OR for heterozygotes was 1.1 (95% CI: 0.7-1.7). The FXII 46 C->T mutation was detected in 46.0% of the patients and in 48.6% of the controls. The OR for heterozygotes was 0.9 (95% CI: 0.6-1.4) and for homozygotes the OR was 0.8 (95% CI: 0.3-1.9). Our data indicate that the FXII 46 C->T mutation is unlikely to be a major risk factor for venous thrombotic disease. In contrast, the homozygous state for FXIII Val34Leu is a strong protective factor against venous thrombosis, which emerges as a novel genetic factor involved in the aetiology of thrombophilia.
最近有报道称,凝血因子XIII基因(FXIII Val34Leu)的突变可预防心肌梗死,但其与静脉血栓形成的关系尚不清楚。此外,还发现了凝血因子XII基因5'-非翻译区的一个突变(46 C->T),该突变与血浆中该蛋白水平较低有关。其在静脉血栓形成患者中的患病率也未知。我们调查了189例深静脉血栓形成患者和187例年龄、性别和种族匹配的对照中FXIII Val34Leu和FXII 46 C->T突变的频率。在38.6%的患者和41.2%的对照中检测到FXIII Val34Leu。有趣的是,1.6%的患者和9.6%的对照中发现了FXIII突变的纯合子,静脉血栓形成的优势比(OR)为0.16(95%CI:0.05-0.5)。杂合子的OR为1.1(95%CI:0.7-1.7)。在46.0%的患者和48.6%的对照中检测到FXII 46 C->T突变。杂合子的OR为0.9(95%CI:0.6-1.4),纯合子的OR为0.8(95%CI:0.3-1.9)。我们的数据表明,FXII 46 C->T突变不太可能是静脉血栓性疾病的主要危险因素。相比之下,FXIII Val34Leu的纯合状态是预防静脉血栓形成的强大保护因素,这是一种参与血栓形成病因的新遗传因素。