Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.
Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
Int J Lab Hematol. 2022 Jun;44(3):626-634. doi: 10.1111/ijlh.13804. Epub 2022 Feb 2.
Antithrombin (AT), protein C (PC), and protein S (PS) are natural anticoagulant proteins that deficiency in each of them is associated with an increased risk of venous thromboembolism.The overlapping of plasma levels of AT, PC, and PS between healthy individuals and heterozygote carriers poses significant challenges in precise diagnosis. This study aimed to evaluate the effect of most influencing variables on plasma levels of these proteins and propose specific reference intervals to improve the interpretation of the laboratory results.
This study was conducted on 1464 individuals who were referred to Massoud medical laboratory, Tehran, Iran, from 2019 to 2020. AT and PC were measured through chromogenic assay and PS plasma level with the clot-based assay. A multivariable linear regression model was performed to evaluate the effect of sex, age, oral contraceptive (OCP) intake, and menopause state. Normal deviate z value was used for different subgroups to justify the need for a separate reference interval.
1200 verified healthy individuals (434 males and 766 females), aged between 18 and 69 years were included in the study. The mean ± SD age of the participants was 39.78 ± 11.79 years. The age-related effects for AT were found in men. In females, increasing age was associated with a rise in AT, PC, and PS plasma levels. No sex difference was found in AT plasma level. OCP-taking is associated with a decrease in AT and an increase in PC plasma levels.
This is the largest study ever conducted on healthy individuals in the Iranian population, using specific reference interval results in accurate diagnosis of true AT, PC, and PS deficiency.
抗凝血酶 (AT)、蛋白 C (PC) 和蛋白 S (PS) 是天然抗凝蛋白，它们中的任何一种缺乏都会增加静脉血栓栓塞的风险。健康个体和杂合子携带者之间的 AT、PC 和 PS 血浆水平重叠，这给精确诊断带来了重大挑战。本研究旨在评估影响这些蛋白质血浆水平的最主要变量，并提出特定的参考区间，以改善实验室结果的解释。
本研究于 2019 年至 2020 年在伊朗德黑兰的 Massoud 医学实验室对 1464 名个体进行。通过显色法测定 AT 和 PC，通过基于凝块的测定法测定 PS 血浆水平。采用多元线性回归模型评估性别、年龄、口服避孕药 (OCP) 摄入和绝经状态的影响。使用不同亚组的正态偏离 z 值来证明需要单独的参考区间。
本研究纳入了 1200 名经证实的健康个体（434 名男性和 766 名女性），年龄在 18 至 69 岁之间。参与者的平均年龄为 39.78±11.79 岁。男性 AT 存在年龄相关的影响，女性中随年龄增长 AT、PC 和 PS 血浆水平升高。AT 血浆水平在性别之间无差异。OCP 摄入与 AT 降低和 PC 血浆水平升高相关。
这是迄今为止在伊朗人群中进行的最大规模的健康个体研究，使用特定的参考区间可准确诊断真正的 AT、PC 和 PS 缺乏症。
