Ethn Dis. 2014 Spring;24(2):169-74.
Venous thromboembolism (VTE) affects more than 300,000 people in the United States each year. However, it has been estimated that current diagnostic testing fails to identify prothrombotic risk in 50% of VTE patients. This article examines the relationship between levels of the pro-coagulant proteins factor VIII (FVIII), von Willebrand factor (VWF), and fibrinogen and risk of VTE in order to assess the impact of these novel risk factors. Data were collected from patients enrolled in the matched case-control Genetic Attributes and Thrombosis Epidemiology study. Crude and adjusted conditional logistic regression models were used to assess the impact of FVIII, VWF, and fibrinogen on risk of VTE. Before adjustment for independent predictors of VTE risk, high levels of FVIII, VWF, and fibrinogen were significantly associated with increased risk of VTE in both Blacks and Whites. After adjustment for ABO type, factor VII levels, hypertension, renal disease, recent surgery, diabetes, annual household income, alcohol use, and the other proteins of interest (FVIII, VWF, and/or fibrinogen), high FVIII and VWF levels were associated with increased risk of VTE in Blacks (OR: 1.97 [1.01-3.84] and 3.39 [1.58-7.27], respectively). High FVIII only was significantly associated with risk of VTE in Whites (OR: 2.35 [1.16-4.75]). Future research into the inclusion of these protein levels in risk models for VTE could help identify persons at highest risk.
静脉血栓栓塞症（VTE）影响了美国每年超过 30 万人。然而，据估计，目前的诊断检测未能识别出 50%的 VTE 患者存在血栓形成风险。本文研究了促凝蛋白因子 VIII（FVIII）、血管性血友病因子（VWF）和纤维蛋白原的水平与 VTE 风险之间的关系，以评估这些新的危险因素的影响。数据来自参加匹配病例对照遗传属性和血栓形成流行病学研究的患者。采用非条件逻辑回归模型来评估 FVIII、VWF 和纤维蛋白原对 VTE 风险的影响。在未调整 VTE 风险的独立预测因素之前，FVIII、VWF 和纤维蛋白原水平升高与黑人和白人的 VTE 风险增加显著相关。在调整 ABO 血型、因子 VII 水平、高血压、肾脏疾病、近期手术、糖尿病、家庭年收入、饮酒和其他感兴趣的蛋白质（FVIII、VWF 和/或纤维蛋白原）后，FVIII 和 VWF 水平升高与黑人 VTE 风险增加相关（比值比：1.97[1.01-3.84]和 3.39[1.58-7.27]）。只有 FVIII 水平升高与白人 VTE 风险增加显著相关（比值比：2.35[1.16-4.75]）。未来对这些蛋白水平纳入 VTE 风险模型的研究可能有助于确定风险最高的人群。
