Reduced factor VII and factor VIII levels and prolonged thrombin-generation times during a healthy diet in middle-aged women with mild to moderate cardiovascular disease risk.
BACKGROUND
No experimental study has investigated the effect of whole-diet therapies on a wide range of hemostatic parameters, and their relationship with metabolic and inflammatory markers. Such information was sought in middle-aged women with moderate cardiovascular disease (CVD) risk subjected to an integrated healthy diet.


METHODS
Forty-nine premenopausal women were screened for C-reactive protein levels > or =1 mg L(-1) and at least one additional CVD risk factor. Sixteen women (age: 43-54 years) were selected and received a 12-week diet (four phases) integrating National Cholesterol Education Program-Adult Treatment Panel-III recommendations with components of a Mediterranean-style diet.


RESULTS
We observed a reduction in body mass index (BMI) (P = 0.001), waist circumference (P = 0.005), total (P = 0.011) and low-density lipoprotein (LDL) cholesterol levels (P = 0.035). Antigen levels of coagulation factor (F)VII (P = 0.003) and FVIII (P = 0.005) were clearly reduced by dietary intervention, which also appeared to decrease circulating tissue factor but not fibrinogen and von Willebrand factor (VWF) antigen levels. Levels of FVIII and tumor necrosis factor-alpha, among the inflammation markers, showed the highest correlation, particularly before the intervention (r = 0.55, P = 0.032). Only this cytokine influenced FVIII variation over time, thus highlighting new relations between coagulation and cellular components of inflammation. The functional effect of diet on coagulation was indicated by markedly prolonged thrombin generation initiation and propagation times (lag time, P = 0.002; time to peak, P = 0.005).


CONCLUSIONS
The changes observed in coagulation initiation and amplification phases, body composition and lipid profile could translate into a remarkable decrease in the risk for cardiovascular disease. Our observations suggest novel relationships between coagulation and inflammatory components.
Passaro
A
A
Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
Calzavarini
S
S
Volpato
S
S
Caruso
P
P
Poli
A
A
Fellin
R
R
Bernardi
F
F
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood* / Q000178:diet therapy*; D004032:Diet; D038441:Diet, Mediterranean; D005167:Factor VII / Q000032:analysis*; D005169:Factor VIII / Q000032:analysis*; D005260:Female; D006487:Hemostasis; D006801:Humans; D007249:Inflammation; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D012306:Risk; D013918:Thrombin Time
D015415:Biomarkers; D008055:Lipids; D005167:Factor VII; D005169:Factor VIII