Wang Zaimin, Rowley Kevin, Best James, McDermott Robyn, Taylor Michael, O'Dea Kerin
Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, VIC, Australia.
Metabolism. 2007 May;56(5):629-35. doi: 10.1016/j.metabol.2006.12.009.
Hemostatic processes are important in precipitating myocardial infarction and stroke. Elevated plasma fibrinogen is considered a risk factor for cardiovascular diseases (CVDs), but the results of previous studies on the association of plasma factor VIIc activity with CVD and diabetes have been inconsistent. The aim of the present study was to explore the association of plasma fibrinogen and factor VIIc to clinical characteristics and estimated coronary heart disease (CHD) risk in Aboriginal and Torres Strait Islander peoples. Cross-sectional surveys of Australian Aboriginal people (n = 852) and Torres Strait Islanders (n = 276) aged 15 years and older were conducted from 1993 to 1995. Anthropometric characteristics, blood pressure, fasting plasma fibrinogen, factor VIIc, total and high-density lipoprotein cholesterol, triglycerides, and glucose were measured. Levels of fibrinogen (mean, 95% confidence interval) for Aboriginal (3.52, 3.44-3.59 g/L) and Torres Strait Islander people (3.62, 3.49-3.75 g/L) were higher compared with previous reports from other populations. Factor VIIc (mean, 95% confidence interval) was especially high in Torres Strait Islanders (116%, 111%-122%) compared with Aboriginal people (99%, 97%-102%). Fibrinogen increased with age in both ethnic groups and sexes. Fibrinogen was independently associated with female sex, body mass index, renal dysfunction, low levels of high-density lipoprotein cholesterol and diabetes, whereas the independent predictors for factor VIIc were Torres Strait Islander ethnicity, female sex, body mass index, renal dysfunction, and total cholesterol. Average fibrinogen levels were high (>3.5 mg/dL) even for people considered "below average risk of coronary heart disease" according to conventional risk factor levels. For Aboriginal women, levels of fibrinogen and factor VIIc were significantly higher for persons at high risk than those at below average risk. The data suggest that plasma fibrinogen and factor VIIc might be important factors mediating the elevated CVD in Australian Indigenous Peoples. These data may have implications for prevention and treatment of CVD in Australian Indigenous communities.
止血过程在引发心肌梗死和中风方面具有重要意义。血浆纤维蛋白原升高被认为是心血管疾病（CVD）的一个危险因素，但先前关于血浆凝血因子VIIc活性与CVD及糖尿病关联的研究结果并不一致。本研究的目的是探讨澳大利亚原住民和托雷斯海峡岛民血浆纤维蛋白原和凝血因子VIIc与临床特征及估计冠心病（CHD）风险之间的关联。1993年至1995年对15岁及以上的澳大利亚原住民（n = 852）和托雷斯海峡岛民（n = 276）进行了横断面调查。测量了人体测量特征、血压、空腹血浆纤维蛋白原、凝血因子VIIc、总胆固醇和高密度脂蛋白胆固醇、甘油三酯以及血糖。与其他人群先前的报告相比，原住民（3.52，3.44 - 3.59 g/L）和托雷斯海峡岛民（3.62，3.49 - 3.75 g/L）的纤维蛋白原水平更高。与原住民（99%，97% - 102%）相比，托雷斯海峡岛民的凝血因子VIIc（均值，95%置信区间）特别高（116%，111% - 122%）。在两个种族群体和不同性别中，纤维蛋白原均随年龄增长而增加。纤维蛋白原与女性性别、体重指数、肾功能不全、高密度脂蛋白胆固醇水平低以及糖尿病独立相关，而凝血因子VIIc的独立预测因素是托雷斯海峡岛民种族、女性性别、体重指数、肾功能不全和总胆固醇。即使是根据传统危险因素水平被认为“冠心病风险低于平均水平”的人群，其平均纤维蛋白原水平也较高（>3.5 mg/dL）。对于原住民女性，高风险人群的纤维蛋白原和凝血因子VIIc水平显著高于风险低于平均水平的人群。数据表明，血浆纤维蛋白原和凝血因子VIIc可能是导致澳大利亚原住民CVD升高的重要因素。这些数据可能对澳大利亚原住民社区CVD的预防和治疗具有启示意义。
