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Thromb Haemost 2022; 122(01): 067-079
DOI: 10.1055/a-1492-6143
Coagulation and Fibrinolysis

Lifestyle Influences Changes in Fibrin Clot Properties Over a 10-Year Period on a Population Level

Albe Carina Swanepoel 
1   Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
,
Zelda de Lange-Loots 
1   Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
2   Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
,
Marike Cockeran
3   School of Mathematical and Statistical Sciences, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa
,
Marlien Pieters 
1   Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
2   Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
› Author Affiliations
Funding The PURE-SA-NW study was funded by the North-West University, South African National Research Foundation (SANRF), Population Health Research Institute, South African Medical Research Council (SAMRC), the North West Province Health Department, and the South Africa-Netherlands Research Program on Alternatives in Development. Grants from the Academy of Medical Sciences UK (Newton Fund Advanced Fellowship Grant - AMS-NAF1-Pieters) and Research Grants from the SAMRC to M.P. supported hemostasis and genetics work reported herein. None of the funding bodies was involved in the design of the study, collection, analysis, or interpretation of the data or in writing of this manuscript. Opinions expressed and conclusions arrived at are those of the authors and are not to be attributed to the funding sources.
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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

Supplementary Material



Publication History

Received: 23 February 2021

Accepted: 25 April 2021

Accepted Manuscript online:
27 April 2021

Article published online:
18 June 2021

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