title: Independent prediction of metabolic syndrome by plasma fibrinogen in men, and predictors of elevated levels.
abstract: The role of plasma fibrinogen levels in predicting metabolic syndrome (MetS) and assessment of determinants of these levels were investigated. A total of 2234 men and women, aged 49+/-12 years, representative of Turkish adults who had plasma fibrinogen determinations, were prospectively evaluated and followed for a mean of 6.6 years. The modified Clauss method was used for assays. MetS was defined by ATPIII criteria modified for male abdominal obesity. MetS cases at baseline were excluded in prospective analyses. Median (interquartile range) fibrinogen values were 2.87 (2.29; 3.56) g/L. Fibrinogen levels predicted significantly newly developing MetS in men (RR 1.40 [95%CI 1.07; 1.83] for a 2-fold increment), after adjustment for age and smoking status, and (RR 1.32 [95%CI 0.95; 1.83] again for doubling), after additional adjustment for all 5 components of MetS. MetS was not significantly predicted by fibrinogen levels in women in either multivariable model. By regression analysis of eight covariates, not waist circumference, but systolic blood pressure, current smoking and C-reactive protein (CRP) in men, and age in women were predictors of elevated (>3.0 g/L) fibrinogen at follow-up (p<0.05 in all).
  
  
  CONCLUSIONS
  Plasma fibrinogen predicts MetS independently of its components in men, in contradistinction to women, and, hence, is likely one of its components. Hyperfibrinogenemia representing an inflammatory state is postulated as the underlying mechanism. Central obesity is linked to elevation in fibrinogen mainly through the mediation of blood pressure, CRP, and via being affected by cigarette smoking.
authors.affiliation: Turkish Society of Cardiology, Istanbul University, Turkey. alt_onat@yahoo.com.tr
authors.forename: Altan
authors.initials: A
authors.lastname: Onat
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozhan
authors.forename: Enver
authors.initials: E
authors.lastname: Erbilen
authors.forename: Sinan
authors.initials: S
authors.lastname: Albayrak
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Küçükdurmaz
authors.forename: Günay
authors.initials: G
authors.lastname: Can
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Keleş
authors.forename: Gülay
authors.initials: G
authors.lastname: Hergenç
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000097:blood / Q000453:epidemiology; D014421:Turkey / Q000453:epidemiology
chemical_list: D005340:Fibrinogen; D002097:C-Reactive Protein