Distribution, genetic and cardiovascular determinants of FVIII:c — Data from the population-based Gutenberg Health Study

Abstract Background Elevated levels of FVIII:c are associated with risk for both venous and arterial thromboembolism. However, no population-based study on the sex-specific distribution and reference ranges of plasma FVIII:c and its cardiovascular determinants is available. Methods FVIII:c was analyzed in a randomly selected sample of 2533 males and 2440 females from the Gutenberg Health Study in Germany. Multivariable regression analyses for FVIII:c were performed under adjustment for genetic determinants, cardiovascular risk factors and cardiovascular disease. Results and conclusions Females (126.6% (95% CI: 125.2/128)) showed higher FVIII:c levels than males (121.2% (119.8/122.7)). FVIII:c levels increased with age in both sexes (ß per decade: 5.67% (4.22/7.13) male, 6.15% (4.72/7.57) female; p < 0.001). Sex-specific reference limits and categories indicating the grade of deviation from the reference were calculated, and nomograms for FVIII:c were created. FVIII:c was approximately 25% higher in individuals with non-O blood type. Adjusted for sex and age, ABO-blood group accounted for 18.3% of FVIII:c variation. In multivariable analysis, FVIII:c was notably positively associated with diabetes mellitus, obesity, hypertension and dyslipidemia and negatively with current smoking. In a fully adjusted multivariable model, the strongest associations observed were of elevated FVIII:c with diabetes and peripheral artery disease in both sexes and with obesity in males. Effects of SNPs in the vWF , STAB2 and SCARA5 gene were stronger in females than in males. The use of nomograms for valuation of FVIII:c might be useful to identify high-risk cohorts for thromboembolism. Additionally, the prospective evaluation of FVIII:c as a risk predictor becomes feasible.