Abstract
Case–control and observational studies have provided a plausible mechanistic link
between clot structure and thrombosis. We aimed to identify lifestyle, demographic,
biochemical, and genetic factors that influence changes in total fibrinogen concentration
and clot properties over a 10-year period in 2,010 black South Africans. Clot properties
were assessed with turbidimetry and included lag time, slope, maximum absorbance,
and clot lysis time. Linear mixed models with restricted maximum likelihood were used
to determine whether (1) outcome variables changed over the 10-year period; (2) demographic
and lifestyle variables, biochemical variables, and fibrinogen single-nucleotide polymorphisms
influenced the change in outcome variables over the 10-year period; and (3) there
was an interaction between the exposures and time in predicting the outcomes. A procoagulant
risk score was furthermore created, and multinomial logistic regression was used to
determine the exposures that were associated with the different risk score categories.
In this population setting, female gender, obesity, poor glycemic control, increased
low-density lipoprotein cholesterol, and decreased high-density lipoprotein cholesterol
contributed to the enhanced progression to prothrombotic clot properties with increasing
age. Alcohol consumption on the other hand, offered a protective effect. The above
evidence suggest that the appropriate lifestyle changes can improve fibrin clot properties
on a population level, decreasing cardiovascular disease risk and thus alleviate the
strain on the medical health care system.
Keywords
fibrinogen - γ' fibrinogen - fibrin clot properties - epidemiology - lifestyle
