Plasma fibrinogen: levels and correlates in young adults. The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Sufficient evidence exists that plasma fibrinogen is a risk factor for cardiovascular disease to prompt a search for fibrinogen determinants. The authors measured fibrinogen in 4,193 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study with three objectives: to describe fibrinogen levels in young adults, to determine if correlates of fibrinogen in older adults apply to younger adults, and to examine several additional hypothesized correlates. Fibrinogen (overall mean +/- standard deviation = 263 +/- 57 mg/dl) was greater in women than in men and in blacks than in whites; it was associated positively with cigarette smoking, body mass index, low density lipoprotein cholesterol, triglycerides, and blood pressure, and negatively with physical activity, high density lipoprotein cholesterol, and ethanol intake. Socioeconomic stress indicators and negative personality traits hypothesized as being associated with fibrinogen, possibly through adrenergic mechanisms, proved weak correlates. Parental history of diabetes was correlated positively with fibrinogen, in part because those with a positive parental history had greater body mass. Diabetes mellitus, lipoprotein(a), left ventricular mass, and oral contraceptive use were also positively correlated with fibrinogen concentration. Thus, even in young adults, fibrinogen is associated positively with most risk factors for atherosclerotic cardiovascular disease. This has implications for the role of fibrinogen as a risk factor and, potentially, for cardiovascular disease prevention.

Impact of weight loss on plasminogen activator inhibitor (PAI-1), factor VII, and other hemostatic factors in moderately overweight adults.

Based on previous cross-sectional findings, we hypothesized that weight loss could improve several hemostatic factors associated with cardiovascular disease. In a randomized controlled trial, moderately overweight men and women were assigned to one of four weight loss treatment groups or to a control group. Measurements of plasminogen activator inhibitor-1 (PAI-1) antigen, tissue-type plasminogen activator (t-PA) antigen, D-dimer antigen, factor VII activity, fibrinogen, and protein C antigens were made at baseline and after 6 months in 90 men and 88 women. Net treatment weight loss was 9.4 kg in men and 7.4 kg in women. There was no net change (p > 0.05) in D-dimer, fibrinogen, or protein C with weight loss. Significant (p < 0.05) decreases were observed in the combined treatment groups compared with the control group for mean PAI-1 (31% decline), t-PA antigen (24% decline), and factor VII (11% decline). Decreases in these hemostatic variables were correlated with the amount of weight lost and the degree that plasma triglycerides declined; these correlations were stronger in men than women. These findings suggest that weight loss can improve abnormalities in hemostatic factors associated with obesity.