Chair of Epidemiology, University of Augsburg, 86156 Augsburg, Germany.
Institute of Epidemiology, Helmholtz Zentrum München, 85764 Neuherberg, Germany.
Medicina (Kaunas). 2023 Jan 26;59(2):228. doi: 10.3390/medicina59020228.
: In contrast to studies in patients, an association between obesity and blood coagulation factors has not been established in the population. If confirmed it could become a target for primary prevention. : To investigate the relationship between Body Mass Index (BMI) and waist circumference (WC) with plasma concentrations of antithrombin III, D-dimers, fibrinogen D, protein S, factor VIII, activated partial thromboplastin time (aPTT), quick value, and international normalized ratio (INR) in the general population. Materials and : Participants of the Cooperative Health Research in the Region of Augsburg (KORA) S4 study who took part in the KORA Fit follow-up (2018-2019, aged 54-74 years) examination were eligible. Citrate plasma samples were collected in fasted participants. After the exclusion of participants with anticoagulative treatment, 776 participants (420 women and 356 men) with analytic data on hemostatic factors were included in the present analysis. Linear regression models were used to explore the association between BMI or WC with hemostatic markers, adjusted for sex, age, alcohol consumption, education, smoking status, and physical activity. In a second model, additional adjustments were made for the prevalence of stroke, hypertension, myocardial infarction, serum non-HDL cholesterol, and serum triglycerides. : In the multivariable models (with or without health conditions), significant positive associations with BMI were obtained for plasma concentrations of D-dimers, factor VIII, fibrinogen D, protein S, and quick value, while INR and antithrombin III were inversely associated. Similar to BMI, WC was significantly associated with all hemostatic factors, except for aPTT. : In this population-based study, both increasing BMI and WC affect the blood coagulation system. Thus, modification of a prothrombotic coagulation profile emerged as a potential target for primary prevention in obese subjects.
与患者研究相反，肥胖与凝血因子之间的关联尚未在人群中得到证实。如果得到证实，它可能成为一级预防的目标。
研究普通人群中体重指数（BMI）和腰围（WC）与抗凝血酶 III、D-二聚体、纤维蛋白原 D、蛋白 S、VIII 因子、活化部分凝血活酶时间（aPTT）、快速值和国际标准化比值（INR）血浆浓度之间的关系。
参加奥格斯堡合作健康研究（KORA）S4 研究并参加 KORA Fit 随访（2018-2019 年，年龄 54-74 岁）检查的参与者符合条件。空腹参与者采集柠檬酸盐血浆样本。排除抗凝治疗的参与者后，本分析纳入了 776 名具有止血因子分析数据的参与者（420 名女性和 356 名男性）。线性回归模型用于探索 BMI 或 WC 与止血标志物之间的关联，调整性别、年龄、饮酒、教育、吸烟状况和身体活动。在第二个模型中，还针对中风、高血压、心肌梗死、血清非高密度脂蛋白胆固醇和血清甘油三酯的患病率进行了额外调整。
在多变量模型中（有或没有健康状况），与 BMI 呈显著正相关的是血浆 D-二聚体、VIII 因子、纤维蛋白原 D、蛋白 S 和快速值，而 INR 和抗凝血酶 III 呈负相关。与 BMI 相似，WC 与除 aPTT 外的所有止血因子均显著相关。
在这项基于人群的研究中，BMI 和 WC 的增加都影响凝血系统。因此，肥胖人群中血栓形成前凝血谱的改变可能成为一级预防的潜在目标。
