Distribution and correlates of plasma fibrinogen in middle-aged women. Initial findings of the Postmenopausal Estrogen/Progestin Interventions (PEPI) study.
Distribution and correlates of plasma fibrinogen in middle-aged women. Initial findings of the Postmenopausal Estrogen/Progestin Interventions (PEPI) study.
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中年女性血浆纤维蛋白原的分布及其相关性。
DOI：
10.1161/01.atv.15.12.2085
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Bush,TL
中科院分区：
文献类型：
--
作者：
Stefanick,ML;Legault,C;Tracy,RP;Howard,G;Kessler,CM;Lucas,DL;Bush,TL
在队列研究和病例对照研究中，纤维蛋白原水平与冠心病的发生呈正相关。本报告介绍了纤维蛋白原的分布和决定因素的妇女参加了3年的随机试验激素替代治疗（HRT），绝经后雌激素/孕激素干预（PEPI）试验。空腹血浆纤维蛋白原水平测定874绝经后妇女，年龄45至65岁，谁没有使用HRT至少3.5个月。平均（±SD）纤维蛋白原水平为2.83±0.45 g/L。纤维蛋白原与年龄之间存在显著正相关（P= 0.03）。显著更高（P<.005）纤维蛋白原水平在目前吸烟者与非吸烟者之间存在差异。（2.94 vs 2.81 g/L），在基线访视前12个月内报告饮酒少于12杯的女性中，（2.90与2.79 g/L），以及从未与曾经使用HRT的女性（2.90与2.77 g/L）。自我报告的休闲时间体力活动（LTPA）呈负相关（P=.0001）纤维蛋白原水平如下：非活动（2.84克/升），轻度（2.89克/升），中度（2.80 g/L），重（2.60克/升），具有显著（P=.0001）较低的水平，妇女谁报告重LTPA与其他类别和妇女报告中度与轻度LTPA。纤维蛋白原与体重指数（BMI）之间存在很强的正相关（r= 0.32;P<0.0001）。在包括年龄、吸烟、饮酒、既往HRT、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子，而与其他变量的相关性仍然显著。纤维蛋白原与腰围、臀围、大腿围和腰臀比呈正相关（P<0.001），但校正BMI后，这些关系不再显著。相反，在同时校正年龄、吸烟、饮酒、HRT、LTPA和BMI后，与HDL胆固醇的负相关（r=-0.25;P <0.001）和与LDL胆固醇的正相关（r= 0.16;P<0.001）仍然显著（分别为P<0.01和P <0.05）。在多变量分析中，纤维蛋白原和甘油三酯、口服葡萄糖前后的胰岛素和葡萄糖水平以及血压之间没有统计学显著的单变量相关性。总之，较高的纤维蛋白原水平被证明是显着和独立相关的几个主要的生活方式和身体特征，已知与心血管疾病的风险增加的妇女。
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. Fibrinogen was positively associated (P<.001) with waist, hip, and thigh girths and waist-to-hip ratio, but these relationships were no longer significant after adjustment for BMI. In contrast, negative associations with HDL cholesterol (r=−.25;P<.001) and positive associations with LDL cholesterol (r=.16;P<.001) remained significant (P<.01 andP<.05, respectively) after simultaneous adjustment for age, smoking, alcohol, prior HRT, LTPA, and BMI. Statistically significant univariate associations between fibrinogen and triglycerides, insulin and glucose levels before and after oral glucose, and blood pressure were not seen in multivariate analyses. In summary, higher fibrinogen levels were shown to be significantly and independently related to several major lifestyle and physical characteristics known to be associated with increased risk of cardiovascular disease in women.