Hansen J B, Grimsgaard S, Huseby N, Sandset P M, Bønaa K H
Department of Medicine, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Thromb Res. 2001 Apr 1;102(1):3-13. doi: 10.1016/s0049-3848(01)00215-8.
Formation of an occlusive thrombus by exposure of tissue factor (TF) to circulating blood and subsequent triggering of coagulation by TF-activated factor VII (FVIIa) complexes on ruptured atherosclerotic plaques is thought to be a key event in myocardial infarction. Tissue factor pathway inhibitor (TFPI) is a potent inhibitor of TF-induced coagulation in which the anticoagulant function most probably is restricted to free TFPI in human plasma. The present study was undertaken to assess the interrelations between serum lipids and components of TF-induced coagulation in 234 apparently healthy men aged 36-56 years recruited from the general population. Plasma free TFPI antigen (Ag) was positively correlated (P < .001) with total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, apolipoprotein B (apoB-100), fibrinogen, total amount of FVII (FVIIam), coagulation activity of factor VII (FVIIc), and FVIIa. The significant predictors for free TFPI Ag were total cholesterol, triglycerides, fibrinogen, FVIIc, and age, which explained 33% of the plasma variation in free TFPI Ag assessed by multiple regression analysis. A highly significant (P < .0001) linear trend for increase in atherogenic lipids (i.e., total cholesterol and triglycerides), FVII (i.e., FVIIc and FVIIa), and fibrinogen across quartiles of TFPI Ag was demonstrated after adjustment for confounders. These findings may indicate a compensatory increase in plasma free TFPI with lipid and hemostatic risk factors for atherothrombotic diseases in healthy middle-aged men.
组织因子（TF）暴露于循环血液以及随后由TF激活的因子VII（FVIIa）复合物在破裂的动脉粥样硬化斑块上触发凝血从而形成闭塞性血栓，被认为是心肌梗死的关键事件。组织因子途径抑制剂（TFPI）是TF诱导凝血的有效抑制剂，其抗凝功能很可能仅限于人血浆中的游离TFPI。本研究旨在评估从普通人群中招募的234名年龄在36 - 56岁之间的表面健康男性的血脂与TF诱导凝血成分之间的相互关系。血浆游离TFPI抗原（Ag）与总胆固醇、低密度脂蛋白（LDL）胆固醇、甘油三酯、载脂蛋白B（apoB - 100）、纤维蛋白原、FVII总量（FVIIam）、因子VII凝血活性（FVIIc）和FVIIa呈正相关（P <.001）。游离TFPI Ag的显著预测因素是总胆固醇、甘油三酯、纤维蛋白原、FVIIc和年龄，通过多元回归分析评估，这些因素解释了血浆中游离TFPI Ag变化的33%。在对混杂因素进行调整后，显示出TFPI Ag四分位数间致动脉粥样硬化脂质（即总胆固醇和甘油三酯）、FVII（即FVIIc和FVIIa）和纤维蛋白原呈高度显著（P <.0001）的线性增加趋势。这些发现可能表明健康中年男性血浆游离TFPI随动脉粥样硬化血栓形成疾病的脂质和止血危险因素出现代偿性增加。
