Cushman M, Yanez D, Psaty B M, Fried L P, Heiss G, Lee M, Polak J F, Savage P J, Tracy R P
Department of Pathology and Medicine, University of Vermont, Burlington, VT, USA.
Am J Epidemiol. 1996 Apr 1;143(7):665-76. doi: 10.1093/oxfordjournals.aje.a008799.
The cross-sectional correlates of three hemostatic factors--fibrinogen, factor VII, and factor VIII--were examined in the Cardiovascular Health Study, a population-based cohort study of 5,201 subjects over age 65 years. Subjects were recruited in 1989-1990 in Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Pittsburgh, Pennsylvania. In multivariate linear regression models, cardiac risk factors significantly associated with fibrinogen were current smoking, race, lipids, and white blood count. In women, alcohol use, obesity, physical activity, and insulin level were also significant, while in men hypertension was correlated. The significant correlates of factor VII were lipids and white blood count in men and estrogen use, alcohol use, race, lipids, insulin level, white blood count, and obesity in women. The independent correlates of factor VIII were insulin, glucose, and race in both sexes; low density lipoprotein cholesterol, white blood count, and diuretic use in men; and alcohol use in women. In multivariate models, factors known to be modifiable risk factors for cardiovascular disease accounted for more of the population variance of these hemostatic factors in women than in men, especially for factor VII. The hemostatic factors may mediate some effects of risk factors on disease, and this should be considered in longitudinal studies.
在心血管健康研究中,对三种止血因子——纤维蛋白原、凝血因子VII和凝血因子VIII——的横断面相关性进行了研究。该研究是一项基于人群的队列研究,共有5201名65岁以上的受试者。研究对象于1989年至1990年在北卡罗来纳州的福赛斯县、加利福尼亚州的萨克拉门托县、马里兰州的华盛顿县以及宾夕法尼亚州的匹兹堡招募。在多变量线性回归模型中,与纤维蛋白原显著相关的心脏危险因素包括当前吸烟、种族、血脂和白细胞计数。在女性中,饮酒、肥胖、身体活动和胰岛素水平也具有显著性,而在男性中高血压与之相关。凝血因子VII的显著相关因素在男性中是血脂和白细胞计数,在女性中是雌激素使用、饮酒、种族、血脂、胰岛素水平、白细胞计数和肥胖。凝血因子VIII的独立相关因素在男女中均为胰岛素、血糖和种族;在男性中是低密度脂蛋白胆固醇、白细胞计数和利尿剂使用;在女性中是饮酒。在多变量模型中,已知为心血管疾病可改变危险因素的因素在女性中比在男性中解释了这些止血因子更多的总体方差,尤其是对于凝血因子VII。止血因子可能介导危险因素对疾病的某些影响,这在纵向研究中应予以考虑。