Determinants of plasma fibrinogen: relation to body weight, waist-to-hip ratio, smoking, alcohol, age, and sex. Results from the second MONICA Augsburg survey 1989-1990.

Abstract

In the second World Health Organization MONItoring Trends and Determinants in CArdiovascular Disease (MONICA) Augsburg survey in 1989-1990 (#1=4,940), the association between nephelometric plasma fibrinogen level and lifestyle-related potential determinants was assessed in 4,434 subjects aged 25-74 years (89.8% of participants). Irrespective of pregnancy and the use of oral contraceptives, crude fibrinogen values were consistently higher in women than in men of all ages (age-standardized difference, 12.2 mg/dl; 95% confidence interval, 7.0-17.4 mg/dl). Fibrinogen concentrations were positively correlated (psO.0001) with age, body mass index, and waist-to-hip ratio in both sexes and with cigarette smoking In men and were negatively correlated with alcohol consumption in both sexes. In multiple linear regression analyses using categorized determinants as independent variables, a strongly J-shaped relation for body mass index in women and a linear association for waist-to-hip ratio in men were revealed. Smoking had a dose-dependent effect on fibrinogen concentration in men but a lesser effect in women. For alcohol consumption a U-shaped association was found, particularly in men. The curvilinear relations were confirmed in multiple polynomial regression models using continuous determinant variables. The potential epidemiological impact of a determinant was assessed by calculating differences in adjusted fibrinogen concentrations associated with the 10th and 90th percentile values of the determinant distributions actually observed among the study participants. This impact on the population fibrinogen level was most pronounced for age in both sexes, followed by body mass index, cigarette smoking, and alcohol consumption in women and by smoking, waist-to-bip ratio, and alcohol consumption in men. About 29% of the total variance in female and 26% in male fibrinogen values were explained by the three lifestyle factors plus age. Our findings are consistent with the hypothesis that fibrinogen may be an etiologic link between certain lifestyle characteristics and the course of cardiovascular disease. {Arterio- sclerosis and Thrombosis 1992;12:780-788) KEY WORDS • fibrinogen • cardiovascular disease risk factors • body mass index • waist-to-hip ratio • cigarette smoking • alcohol consumption T he evidence that clotting factors may be important in the evolution of atherosclerotic vascular disease was initially derived from case-control 1 " 3 and angiographic 4^ studies in which men with clinically manifest coronary heart disease showed elevated mean fibrinogen levels. Further evidence came from a number of prospective epidemiological studies indicating that plasma fibrinogen levels were strongly predictive of coronary heart disease and stroke incidence and mortality. 6 -12 An as-yet-undetermined part of the association between traditional risk factors and cardiovascular disease From the GSF-Institute of Epidemiology

Alcohol consumption and its relation to cardiovascular risk factors in Germany

“…tional studies including high alcohol drinkers suggested a U-shaped curve for the association of alcohol consumption and fibrinogen, particularly among men, with the minimum of the curve ranging between 20 to 60 g alcohol/day (Krobot et al, 1992;Mennen et al, 1999;Mukamal et al, 2001). In this study, no relation between alcohol consumption and antithrombin III was found, while results of other studies remained inconclusive (Kiechl et al, 1996;Mezzano et al, 2001).…”

Physical Activity Status and Adverse Age-Related Differences in Coagulation and Fibrinolytic Factors in Women

“…It has been suggested that the favorable association between plasma fibrinogen levels and regular exercise are likely due, at least in part, to lower body fatness. 28,29 Indeed, in the present study, percent body fat was the primary determinant of plasma fibrinogen level, accounting for approximately one third of the variability.…”

Segregation Analysis of Plasminogen Activator Inhibitor-1 and Fibrinogen Levels in the NHLBI Family Heart Study

“…[40][41][42][43][44] Our study found that 19% to 29% of the variance in plasma fibrinogen concentration could be explained by age and anthropometric, lifestyle, and metabolic factors. The extent to which genetic factors determine the concentration of plasma fibrinogen is not entirely known.…”