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Intrinsic clotting factors in dependency of age, sex, body mass index, and oral contraceptives: definition and risk of elevated clotting factor levels

Luxembourg, Beatea; Schmitt, Joernb; Humpich, Marekc; Glowatzki, Matthiasd; Seifried, Erharde; Lindhoff-Last, Edelgarda

Blood Coagulation & Fibrinolysis: October 2009 - Volume 20 - Issue 7 - p 524–534
doi: 10.1097/MBC.0b013e32832d9b58
ORIGINAL ARTICLES

Elevated clotting factors have been demonstrated to be a risk factor for venous thromboembolism (VTE). The aim of our study was to investigate the impact of age, sex, body mass index, and oral contraceptives on the clotting factor activities of factors VIII, IX, XI, and XII and their impact on the cutoff definition and risk of VTE associated with elevated clotting factors. Factor VIII, IX, XI, and XII activities were measured in 499 blood donors and 286 patients with VTE. Age and body mass index predicted significantly and independently the clotting factor activities of factors VIII, IX, and XI, whereas use of oral contraceptives predicted factor IX, XI, and XII levels. Percentiles of clotting factor activities, which are often used for the cutoff definition of elevated clotting factors, varied due to the effect of age, body mass index, and oral contraceptives. The adjusted odds ratios for VTE were 10.3 [95% confidence interval (CI) 5.1–20.7], 6.1 (95% CI 3.1–12.0), and 3.3 (95% CI 1.9–5.8) for elevated factors VIII, IX, and XI, respectively. Furthermore, our study demonstrates for the first time that elevated factor XII is associated with an increased risk of VTE (adjusted odds ratio 2.9, 95% CI 1.6–5.3).

aDivision of Vascular Medicine and Haemostaseology, Germany

bDivision of Cardiology, Department of Internal Medicine, Germany

cDepartment of Anaesthesiology, Intensive Care Medicine, and Pain Management, University Hospital Frankfurt, Frankfurt, Germany

dSPSS GmbH Software, München, Germany

eInstitute of Transfusion Medicine and Immunohaematology, Blood Transfusion Center of the German Red Cross, Frankfurt, Germany

Received 20 August, 2008

Revised 8 April, 2009

Accepted 10 April, 2009

Correspondence to Dr Beate Luxembourg, MD, Division of Angiology and Haemostaseology, Department of Internal Medicine, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt a.M., Germany Tel: +49 69 6301 5096; fax: +49 69 6301 7219; e-mail: beate.luxembourg@kgu.de

© 2009 Lippincott Williams & Wilkins, Inc.