DIFFERENCES OF CLOTTING FACTORS IN PREDICTING HEALTH-RELATED VARIABLES IN CAUCASIAN AND AFRICAN-AMERICAN WOMEN

Abstract

Hemostatic variables have been shown to predict cardiovascular disease events and have been used to assess coronary artery disease risk. PURPOSE: To determine whether selected clotting factors including fibrinogen, tissue plasminogen activator (TPA), and plasminogen activator inhibitor-1 (PAI-1) could significantly predict health-related variables (HRV) in premenopausal women. METHOD: A total of 36 overweight Caucasian (CC) and 30 overweight African American (AA) women were recruited for measurement of intra abdominal fat and HRV. A multiple regression interaction was used to determine the impact of clotting factors on HRV in both racial groups. RESULT: There were no significant differences between the two groups in age (CC = 41.94 ± 7.10 yrs; AA = 37.97 ± 9.94 yrs) and body mass index (CC = 35.12 ± 5.36 kg'm2; AA = 34.88 ± 4.41 kg'm2). There were also no significant differences between groups in clotting factors or HRV with the exception of triacylglycerol (TG) (p = .009) and volume of visceral adipose tissue (VAT) (p < .001). TPA was an effective predictor of HRV in both groups predicting systolic and diastolic blood pressure (p = 0.004 and p = .002, respectively), high density lipoprotein cholesterol (HDL) (p = .007) and VAT (p = .008) without any race effect. PAI-1 could similarly predict the same HRV and in addition, could predict insulin (p = .017), glucose (p = .036), insulin resistance (IR) using the HOMA model (p = .007), TG (p = .012), HDL2 (p = .026), and total cholesterol/HDL ratio (p = .004). Fibrinogen predicted the fewest HRV. CONCLUSION: Both TPA and PAI-1 were effective predictors of HRV in both groups. PAI-1 could, in addition, be used to predict fasting glucose, insulin, IR in CC and AA women. Given the higher mortality rates from cardiovascular disease and the higher incidence of diabetes in AA women, PAI-1 should be considered the most suitable clotting factor to predict HRV in both groups of women.