Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa.
Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
Thromb Haemost. 2022 Jan;122(1):67-79. doi: 10.1055/a-1492-6143. Epub 2021 Jun 18.
Case-control and observational studies have provided a plausible mechanistic link between clot structure and thrombosis. We aimed to identify lifestyle, demographic, biochemical, and genetic factors that influence changes in total fibrinogen concentration and clot properties over a 10-year period in 2,010 black South Africans. Clot properties were assessed with turbidimetry and included lag time, slope, maximum absorbance, and clot lysis time. Linear mixed models with restricted maximum likelihood were used to determine whether (1) outcome variables changed over the 10-year period; (2) demographic and lifestyle variables, biochemical variables, and fibrinogen single-nucleotide polymorphisms influenced the change in outcome variables over the 10-year period; and (3) there was an interaction between the exposures and time in predicting the outcomes. A procoagulant risk score was furthermore created, and multinomial logistic regression was used to determine the exposures that were associated with the different risk score categories. In this population setting, female gender, obesity, poor glycemic control, increased low-density lipoprotein cholesterol, and decreased high-density lipoprotein cholesterol contributed to the enhanced progression to prothrombotic clot properties with increasing age. Alcohol consumption on the other hand, offered a protective effect. The above evidence suggest that the appropriate lifestyle changes can improve fibrin clot properties on a population level, decreasing cardiovascular disease risk and thus alleviate the strain on the medical health care system.
病例对照和观察性研究为血栓形成与血栓结构之间的潜在机制联系提供了证据。我们旨在确定生活方式、人口统计学、生化和遗传因素，这些因素可能会影响 2010 名南非黑人在 10 年内总纤维蛋白原浓度和血栓特性的变化。采用比浊法评估血栓特性，包括滞后时间、斜率、最大吸光度和血栓溶解时间。使用具有限制最大似然的线性混合模型来确定：(1) 结局变量是否在 10 年内发生变化；(2) 人口统计学和生活方式变量、生化变量和纤维蛋白原单核苷酸多态性是否影响 10 年内结局变量的变化；(3) 暴露与时间之间是否存在交互作用，以预测结局。此外，还创建了一个促凝风险评分，并使用多项逻辑回归来确定与不同风险评分类别的暴露因素。在这种人群环境中，女性、肥胖、血糖控制不佳、低密度脂蛋白胆固醇增加和高密度脂蛋白胆固醇降低会随着年龄的增长导致血栓形成特性向促血栓形成方向发展。另一方面，饮酒则提供了保护作用。上述证据表明，适当的生活方式改变可以改善人群的纤维蛋白凝块特性，降低心血管疾病风险，从而减轻医疗保健系统的负担。
