Factor VII,Cholesterol, and Triglycerides: The CARDIA Study

Cross-sectional studies have shown that factor VII coagulant activity (VIIc) is positively associated with plasma total cholesterol (TC), LDL cholesterol, and triglycerides (TG) as well as body mass index (BMI) and diastolic blood pressure. To determine whether changes in VIIc parallel changes in coronary risk factors over a period of 2 years, we examined data from 1514 participants in the Coronary Artery Risk Development in Young Adults Study (CARDIA), an ongoing investigation of lifestyles and evolution of cardiovascular risk factors. Subjects were 23 to 35 years old at the year 5 examination. Cross-sectional analyses at these examinations showed that VIIc was positively correlated (P < .001) with TC and TG in all race/sex groups except for TC in black women at the year 5 examination. Changes in VII sub c over the 2-year period were correlated positively with changes in TC in all except black men and TG in all groups; the association of VII sub c change with change in TC and TG was reduced only slightly with adjustment for age and BMI at year 5 and 2-year change in BMI. To determine whether the higher levels of VIIc in subjects with higher lipid values were due to activation of the factor or to an increase in the concentration of the factor VII clotting protein, we measured factor VII antigen (VIIag) in a randomly selected subsample of 223 subjects at the year 7 examination. In all sex/race groups, VIIag correlated with VIIc (r = .69 to 0.81). After adjustment for sex and race, the partial correlation coefficient between TG and VIIc was .28 (p = .0001); between TG and VIIag, .35 (P = .0001); between TC and VIIc, .39 (P = .0001); and between TC and VIIag, 0.43 (P = .0001). No associations were observed between lipid levels and the ratio of VIIc to VIIag. We conclude that the raised VIIc with higher lipid levels occurs in blacks as well as whites, in men and women, persists over time, and represents a true increase in the plasma concentration of this clotting factor. (Arterioscler Thromb Vasc Biol. 1997;17:51-55.)