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Kris-Etherton PM, Stewart PW, Ginsberg HN, Tracy RP, Lefevre M, Elmer PJ, Berglund L, Ershow AG, Pearson TA, Ramakrishnan R, Holleran SF, Dennis BH, Champagne CM, Karmally W. The Type and Amount of Dietary Fat Affect Plasma Factor VIIc, Fibrinogen, and PAI-1 in Healthy Individuals and Individuals at High Cardiovascular Disease Risk: 2 Randomized Controlled Trials. J Nutr 2020; 150:2089-2100. [PMID: 32492148 PMCID: PMC7398773 DOI: 10.1093/jn/nxaa137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/12/2019] [Accepted: 04/21/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Factor VIIc, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) are cardiovascular disease (CVD) risk factors and are modulated, in part, by fat type and amount. OBJECTIVE We evaluated fat type and amount on the primary outcomes: factor VIIc, fibrinogen, and PAI-1. METHODS In the Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA) Trial, 2 controlled crossover feeding studies evaluated substituting carbohydrate or MUFAs for SFAs. Study 1: healthy participants (n = 103) were provided with (8 wk) an average American diet [AAD; designed to provide 37% of energy (%E) as fat, 16% SFA], a Step 1 diet (30%E fat, 9% SFA), and a diet low in SFA (Low-Sat; 26%E fat, 5% SFA). Study 2: participants (n = 85) at risk for CVD and metabolic syndrome (MetSyn) were provided with (7 wk) an AAD, a step 1 diet, and a high-MUFA diet (designed to provide 37%E fat, 8% SFA, 22% MUFA). RESULTS Study 1: compared with AAD, the Step 1 and Low-Sat diets decreased mean factor VIIc by 1.8% and 2.6% (overall P = 0.0001), increased mean fibrinogen by 1.2% and 2.8% (P = 0.0141), and increased mean square root PAI-1 by 0.0% and 6.0% (P = 0.0037), respectively. Study 2: compared with AAD, the Step 1 and high-MUFA diets decreased mean factor VIIc by 4.1% and 3.2% (overall P < 0.0001), increased mean fibrinogen by 3.9% and 1.5% (P = 0.0083), and increased mean square-root PAI-1 by 2.0% and 5.8% (P = 0.1319), respectively. CONCLUSIONS Replacing SFA with carbohydrate decreased factor VIIc and increased fibrinogen in healthy and metabolically unhealthy individuals and also increased PAI-1 in healthy subjects. Replacing SFA with MUFA decreased factor VIIc and increased fibrinogen but less than carbohydrate. Our results indicate an uncertain effect of replacing SFA with carbohydrate or MUFA on cardiometabolic risk because of small changes in hemostatic factors and directionally different responses to decreasing SFA. This trial was registered at https://clinicaltrials.gov/ct2/show/NCT00000538?term=NCT00000538&rank=1 as NCT00000538.
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Affiliation(s)
- Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA,Address correspondence to PMK-E (e-mail: )
| | - Paul W Stewart
- Department of Biostatistics, Collaborative Studies Coordinating Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Henry N Ginsberg
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Russell P Tracy
- Colchester Research Facility, University of Vermont, Colchester, VT, USA
| | - Michael Lefevre
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA,Present address for ML: Department of Nutrition, Dietetics and Food Sciences, Utah State University, 9815 Old Main Hill, Logan, UT 84322-9815
| | - Patricia J Elmer
- Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, MN, USA,Present address for PJE: Portland, OR
| | - Lars Berglund
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA,Present address for LB: Clinical and Translational Science Center, UC-Davis, School of Medicine, Sacramento, CA
| | - Abby G Ershow
- Division of Heart and Vascular Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA,Present address for AGE: Office of Dietary Supplements, National Institutes of Health, Bethesda, MD
| | - Thomas A Pearson
- The Mary Imogene Bassett Research Institute, Cooperstown, NY, USA,School of Public Health, State University of New York at Albany, Albany, NY, USA,Columbia University College of Physicians and Surgeons, New York, NY, USA,Department of Community and Preventive Medicine, University of Rochester, Rochester, NY, USA,Present address for TAP: Department of Epidemiology, University of Florida, Gainesville, FL
| | - Rajasekhar Ramakrishnan
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Stephen F Holleran
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Barbara H Dennis
- Department of Biostatistics, Collaborative Studies Coordinating Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Present address for BHD: Chapel Hill, NC
| | - Catherine M Champagne
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Wahida Karmally
- Department of Medicine, Irving Center for Clinical Research, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - for the DELTA Investigators
GinsbergHenryMDPrincipal Investigator12RamakrishnanRajasekharDSc12KarmallyWahidaDrPH RD, CDE12BerglundLarsMD, PhD12SiddiquiMalihaMS, RD12ChenNiem-TzuMS12HolleranSteveBS12JohnsonColleenRD12HolemanRoberta12ChirgwinKaren12StennettKellye12GangaLencey12TowolawaiTajsudeenMBA12MyersMinnieBS12NgaiColleenBS12FontenezNelsonBS12JonesJeffBS12RodriguezCarmen12UsecheNorma12LefevreMichaelPhD13RoheimPaul SMDCo-Principal Investigators13
Deceased RyanDonnaMD13MostMarlenePhD, RD13ChampagneCatherinePhD, RD13WilliamsonDonaldPhD13TulleyRichardPhD13BrockRickyRN13BodinDeonneBS, MT13KennedyBettyMPA13BarkateMichelleMS, RD13FoustElizabethBS13YorkDeshoinBS13Kris-EthertonPennyPhD, RDPrincipal Investigator14JonnalagaddaSatyaPhD14DerrJanicePhD14Farhat-WoodAbirMS14MustadVikkiePhD14MeakerKateMS14MillsEdwardPhD14TilleyMary-AnnMS, RD14Smiciklas-WrightHelenPhD14Sigman-GrantMadeleinePhD, RD14YuShaomeiMS, PhD14GuinardJean-XavierPhD14SechevichPamelaMS14ReddyC ChannaPhD14MastroAndrea MPhD14CooperAllen DMD14ElmerPatriciaPhDPrincipal Investigator15FolsomAaronMD15Van HeelNancyMS, RD15WoldChristineRD15FritzKayMA, RD15SlavinJoannePhD15JacobsDavidPhD15DennisBarbaraPhDFirst Principal Investigator16StewartPaulPhDSecond Principal Investigator16DavisCPhD16HoskingJamesPhD16AndersonNancyMSPH16BlackwellSusanBS16MartinLynnMS16BryanHopeMS16StewartW BrianBS16AbolafiaJeffreyMA16FoleyMalachyBS16ZienConroyBA16LeuSzu-YunMS16YoungbloodMarstonMPH16GoodwinThomasMAT16MilesMonica16WehbieJennifer16PearsonThomasMD, PhD17ReedRobertaPhD17TracyRussellPhD18CornellElaineBS18StewartKentPhD19PhillipsKatherinePhD19McGeeBernestinePhD, RD20WilliamsBrendaBS20BeecherGaryPhD21HoldenJoanneMS21DavisCarolBS21ErshowAbbyScD22GordonDavidMD, PhD22ProschanMichaelPhD22RifkindBasilMD, FRCP22Deceased
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Lindman AS, Müller H, Seljeflot I, Prydz H, Veierød M, Pedersen JI. Effects of dietary fat quantity and composition on fasting and postprandial levels of coagulation factor VII and serum choline-containing phospholipids. Br J Nutr 2003; 90:329-36. [PMID: 12908893 DOI: 10.1079/bjn2003911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dietary fat influences plasma levels of coagulation factor VII (FVII) and serum phospholipids (PL). It is, however, unknown if the fat-mediated changes in FVII are linked to PL. The present study aimed to investigate the effects of dietary fat on fasting and postprandial levels of activated FVII (FVIIa), FVII coagulant activity (FVIIc), FVII protein (FVIIag) and choline-containing PL (PC). In a randomized single-blinded crossover-designed study a high-fat diet (HSAFA), a low-fat diet (LSAFA), both rich in saturated fatty acids, and a high-fat diet rich in unsaturated fatty acids (HUFA) were consumed for 3 weeks. Twenty-five healthy females, in which postprandial responses were studied in a subset of twelve, were included. The HSAFA diet resulted in higher levels of fasting FVIIa and PC compared with the LSAFA and the HUFA diets (all comparisons P< or =0.01). The fasting PC levels after the LSAFA diet were also higher than after the HUFA diet (P<0.001). Postprandial levels of FVIIa and PC were highest on the HSAFA diet and different from LSAFA and HUFA (all comparisons P< or =0.05). Postprandial FVIIa was higher on the HUFA compared with the LSAFA diet (P<0.03), whereas the HUFA diet resulted in lower postprandial levels of PC than the LSAFA diet (P<0.001). Significant correlations between fasting levels of PC and FVIIc were found on all diets, whereas FVIIag was correlated to PC on the HSAFA and HUFA diet. The present results indicate that dietary fat, both quality and quantity, influences fasting and postprandial levels of FVIIa and PC. Although significant associations between fasting FVII and PC levels were found, our results do not support the assumption that postprandial FVII activation is linked to serum PC.
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Bladbjerg EM, Larsen LF, Ostergaard P, Jespersen J. In vitro effects of heparin and tissue factor pathway inhibitor on factor VII assays. possible implications for measurements in vivo after heparin therapy. Blood Coagul Fibrinolysis 2000; 11:739-45. [PMID: 11132652 DOI: 10.1097/00001721-200012000-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The coagulant activity of blood coagulation factor VII (FVII:C) can be lowered by changes in lifestyle and by therapeutic intervention, e.g. heparin infusion. The question is, however, whether FVII:C determined ex vivo is a valid measure of the FVII activity in vivo. We measured plasma FVII:C, activated FVII (FVIIa), FVII protein (FVII:Ag), tissue factor pathway inhibitor (TFPI), triglycerides, and free fatty acids (FFA) before and 15 min after infusion of a bolus of unfractionated heparin (50 IU/kg body weight) in 12 healthy subjects. Additionally, we conducted in vitro experiments to investigate the effect of unfractionated heparin and TFPI, which is released from the endothelium by heparin, on FVII:C, FVIIa, and FVII:Ag. Heparin infusion decreased triglycerides and increased FFA and TFPI. This was accompanied by significant reductions in FVIIa, FVII:C and FVII:Ag. In vitro, anti-TFPI antibodies increased FVIIa and FVII:C, and heparin reduced FVIIa. The heparinase Hepzyme was unable to abolish the effect of heparin. There were no in vitro effects on FVII:Ag. We conclude that, due to interference by TFPI and heparin in post-heparin plasma, it is impossible to measure the in vivo FVII activity by means of FVII clotting assays. These assays should therefore not be used to measure the coagulation status of patients in heparin therapy, unless extraordinary precautions are taken to eliminate TFPI and heparin effects ex vivo. The observed effect of heparin on FVII:Ag should be investigated further.
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Affiliation(s)
- E M Bladbjerg
- Department of Thrombosis Research, University of Southern Denmark, Ribe County Hospital in Esbjerg.
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Barnard ND, Scialli AR, Bertron P, Hurlock D, Edmonds K, Talev L. Effectiveness of a low-fat vegetarian diet in altering serum lipids in healthy premenopausal women. Am J Cardiol 2000; 85:969-72. [PMID: 10760336 DOI: 10.1016/s0002-9149(99)00911-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Few controlled trials have studied cholesterol-lowering diets in premenopausal women. None has examined the cholesterol-lowering effect of a low-fat vegetarian diet, which, in other population groups, leads to marked reductions in serum cholesterol concentrations and, in combination with other life-style changes, a regression of atherosclerosis. We tested the hypothesis that a low-fat, vegetarian diet significantly reduces serum total and low-density lipoprotein (LDL) cholesterol concentrations in premenopausal women. In a crossover design, 35 women, aged 22 to 48, followed a low-fat vegetarian diet deriving approximately 10% of energy from fat for 2 menstrual cycles. For 2 additional cycles, they followed their customary diet while also taking a "supplement" (placebo) pill. Serum lipid concentrations were assessed at baseline and during each intervention phase. Mean serum LDL, high-density lipoprotein (HDL), and total cholesterol concentrations decreased 16. 9%, 16.5%, and 13.2%, respectively, from baseline to the intervention diet phase (p<0.001), whereas mean serum triacylglycerol concentration increased 18.7% (p<0.01). LDL/HDL ratio remained unchanged. Thus, in healthy premenopausal women, a low-fat vegetarian diet led to rapid and sizable reductions in serum total, LDL, and HDL cholesterol concentrations.
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Affiliation(s)
- N D Barnard
- Physicians Committee for Responsible Medicine, Washington DC, USA.
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Miller GJ. Lipoproteins and the haemostatic system in atherothrombotic disorders. Best Pract Res Clin Haematol 1999; 12:555-75. [PMID: 10856985 DOI: 10.1053/beha.1999.0040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The remarkable extent to which interactions between the plasma lipoproteins, inflammatory factors and the haemostatic system contribute to the response to injury and growth of the plaque in atherosclerosis is being increasingly documented. High plasma concentrations of very-low density (VLDL) and low-density lipoproteins (LDL), together with oxidatively modified LDL and lipoprotein (a), can induce responses in vascular endothelial cells, smooth muscle cells, monocytes/macrophages, platelets, neutrophils and humoral factors that are in a variety of ways both procoagulant and antifibrinolytic. Plasma high-density lipoproteins appear to promote anticoagulant mechanisms. Post-prandial lipaemia is associated with transient changes in factor VII which may be indicative of temporary hypercoagulability. The cellular and humoral effects of LDL and VLDL on the haemostatic system appear to be largely reversible, which may help to explain the prompt improvement in the atherothrombotic state gained by correction of hyperlipidaemia.
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Affiliation(s)
- G J Miller
- MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, London, UK
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Eichner JE, Moore WE, Schechter E, Reynolds DW, Morrissey JH, Comp PC. Activated factor VII levels in patients with angiographically confirmed coronary artery disease. Am J Cardiol 1997; 80:217-9. [PMID: 9230166 DOI: 10.1016/s0002-9149(97)00324-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We have examined factor VIIa levels in consecutive consenting patients undergoing coronary angiography (n = 702) to determine if levels are related to the presence of coronary arterial narrowing and to the degree and extent of that narrowing. Both men and women with clinically defined coronary artery disease (> or = 50% stenosis in at least 1 vessel) had factor VIIa levels that were similar to men and women with less stenosis or normal coronary arteries.
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Affiliation(s)
- J E Eichner
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma, Oklahoma Medical Research Foundation, and the Oklahoma City Veterans Hospital, 73190, USA
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