Folsom A R
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, USA.
Eur Heart J. 1995 Mar;16 Suppl A:21-3; discussion 23-4. doi: 10.1093/eurheartj/16.suppl_a.21.
As evidence accumulates to implicate fibrinogen as a risk factor for cardiovascular disease (CVD) it becomes important to characterize the levels and correlates of fibrinogen in diverse populations. Knowledge of the correlates of fibrinogen may help researchers to disentangle the independent contribution of elevated fibrinogen concentrations to CVD. Characterization of the normal range and possible determinants of fibrinogen concentrations, likewise, may aid CVD risk assessment and intervention research. Fibrinogen concentrations vary widely among populations and increase with age. Levels are consistently higher in women than men and rise after menopause. Smoking is the most important lifestyle correlate of fibrinogen. People with diabetes and hypertension have elevated fibrinogen levels, as do sedentary and obese individuals. Alcohol intake and oestrogen replacement therapy are associated with lower fibrinogen levels. Most other CVD risk factors are correlated positively with fibrinogen. Fibrinogen is clearly a marker of CVD risk. Yet, the strikingly non-specific pattern of higher fibrinogen with every CVD risk factor suggests that proving an independent causal role of fibrinogen will remain elusive in the absence of trials selectively lowering fibrinogen with the aim of reducing CVD.
随着越来越多的证据表明纤维蛋白原是心血管疾病（CVD）的危险因素，了解不同人群中纤维蛋白原的水平及其相关因素变得至关重要。了解纤维蛋白原的相关因素可能有助于研究人员厘清纤维蛋白原浓度升高对心血管疾病的独立影响。同样，确定纤维蛋白原浓度的正常范围及其可能的决定因素，可能有助于心血管疾病风险评估和干预研究。不同人群的纤维蛋白原浓度差异很大，且随年龄增长而升高。女性的纤维蛋白原水平始终高于男性，且绝经后会升高。吸烟是与纤维蛋白原最为重要的生活方式相关因素。糖尿病和高血压患者的纤维蛋白原水平升高，久坐不动和肥胖的人也是如此。饮酒和雌激素替代疗法与较低的纤维蛋白原水平相关。大多数其他心血管疾病危险因素与纤维蛋白原呈正相关。纤维蛋白原显然是心血管疾病风险的一个标志物。然而，纤维蛋白原与每种心血管疾病危险因素都呈明显的非特异性升高模式，这表明在缺乏旨在降低纤维蛋白原以减少心血管疾病的试验的情况下，证明纤维蛋白原的独立因果作用仍将难以实现。
