Stefanick M L, Legault C, Tracy R P, Howard G, Kessler C M, Lucas D L, Bush T L
Stanford University, Palo Alto, CA, USA.
Arterioscler Thromb Vasc Biol. 1995 Dec;15(12):2085-93. doi: 10.1161/01.atv.15.12.2085.
Fibrinogen levels have been reported in cohort and case-control studies to be positively related to the development of coronary heart disease. This report presents the distribution and determinants of fibrinogen in women enrolling in a 3-year randomized trial of hormone replacement therapy (HRT), the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial. Fasting plasma fibrinogen levels were measured in 874 postmenopausal women, aged 45 to 65 years, who had not used HRT for at least 3.5 months. Mean (+/- SD) fibrinogen level was 2.83 +/- 0.45 g/L. There was a significant positive association between fibrinogen and age (P = .03). Significantly higher (P < .005) fibrinogen levels were seen in current smokers versus nonsmokers (2.94 versus 2.81 g/L), in women who reported consuming fewer than 12 alcoholic drinks in the 12 months before the baseline visit versus higher consumption (2.90 versus 2.79 g/L), and in women who reported never versus ever having used HRT (2.90 versus 2.77 g/L). Self-reported leisure time physical activity (LTPA) was negatively associated (P = .0001) with fibrinogen levels as follows: inactive (2.84 g/L), light (2.89 g/L), moderate (2.80 g/L), and heavy (2.60 g/L), with significantly (P = .0001) lower levels in women who reported heavy LTPA versus each of the other categories and in women reporting moderate versus light LTPA. A strong positive correlation was found between fibrinogen and body mass index (BMI) (r = .32; P < .0001). In a model that included age, smoking, alcohol intake, prior HRT, LTPA, and BMI, LTPA was no longer a statistically significant predictor of fibrinogen level, while associations with other variables remained significant.(ABSTRACT TRUNCATED AT 250 WORDS)
在队列研究和病例对照研究中,已有报告称纤维蛋白原水平与冠心病的发生呈正相关。本报告介绍了参与一项为期3年的激素替代疗法(HRT)随机试验——绝经后雌激素/孕激素干预(PEPI)试验的女性中纤维蛋白原的分布及其决定因素。对874名年龄在45至65岁之间、至少3.5个月未使用HRT的绝经后女性测量了空腹血浆纤维蛋白原水平。平均(±标准差)纤维蛋白原水平为2.83±0.45g/L。纤维蛋白原与年龄之间存在显著正相关(P = 0.03)。当前吸烟者的纤维蛋白原水平显著高于非吸烟者(2.94对2.81g/L,P < 0.005),在基线访视前12个月内报告饮酒少于12杯的女性与饮酒较多的女性相比(2.90对2.79g/L),以及在报告从未使用过HRT与曾经使用过HRT的女性中(2.90对2.77g/L)亦是如此。自我报告的休闲时间体力活动(LTPA)与纤维蛋白原水平呈负相关(P = 0.0001),具体如下:不活动(2.84g/L)、轻度(2.89g/L)、中度(2.80g/L)和重度(2.60g/L),报告重度LTPA的女性与其他类别相比以及报告中度LTPA与轻度LTPA的女性相比,纤维蛋白原水平显著更低(P = 0.0001)。纤维蛋白原与体重指数(BMI)之间存在强正相关(r = 0.32;P < 0.0001)。在一个包含年龄、吸烟、饮酒量、既往HRT使用情况、LTPA和BMI的模型中,LTPA不再是纤维蛋白原水平的统计学显著预测因素,而与其他变量的关联仍然显著。(摘要截短于250字)