title: Distribution of antiphospholipid antibodies in a large population-based German cohort.
abstract: BACKGROUND
  Antiphospholipid syndrome (APS) is the most common acquired thrombophilia. Diagnosis is based on clinical criteria and the presence of antiphospholipid antibodies (aPLs) above the 99th percentile of a reference group. Data on the distribution of aPL in the population are limited. The distribution of aPL including diagnostic cutoffs should be determined in a population-based cohort.
  
  
  METHODS
  The Gutenberg Health Study (GHS) is a population-based cohort aged 35-74 years. We determined the presence of antibodies against cardiolipin (aCL, IgG, and IgM), β2-glycoprotein I (anti-β2GPI, IgG, and IgM), and domain 1 of β2-glycoprotein I (anti-domain 1, IgG) in a sample of 4979 participants.
  
  
  RESULTS
  aPL titers were similar in the whole sample and in an apparently healthy subgroup of 1049 individuals. There was a strong age-dependent increase of both aCL and anti-β2GPI IgM, while aPL IgG titers were stable or tended to decrease with age. A relevant decrease was observed for aCL IgG in women and anti-domain 1 IgG in both sexes. There was no association of aPL titers with a history of venous thromboembolism (VTE).
  
  
  CONCLUSIONS
  Our data show that for IgM aPL, age-dependent reference ranges should be used. In fact, the controversy regarding the clinical utility of IgM aPL might be related to the use of inappropriate reference ranges among other causes. In our population, aPLs were not associated with a history of VTE.
authors.forename: Davit
authors.initials: D
authors.lastname: Manukyan
authors.forename: Heidi
authors.initials: H
authors.lastname: Rossmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Schulz
authors.forename: Tanja
authors.initials: T
authors.lastname: Zeller
authors.forename: Norbert
authors.initials: N
authors.lastname: Pfeiffer
authors.forename: Harald
authors.initials: H
authors.lastname: Binder
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
authors.forename: Nadine
authors.initials: N
authors.lastname: Müller-Calleja
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Wild
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Lackner
mesh_terms: D000328:Adult; D000368:Aged; D000888:Antibodies, Anti-Idiotypic / Q000097:blood / Q000276:immunology; D017152:Antibodies, Antiphospholipid / Q000097:blood* / Q000276:immunology; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values
chemical_list: D000888:Antibodies, Anti-Idiotypic; D017152:Antibodies, Antiphospholipid; D007074:Immunoglobulin G; C048844:anti-IgG; C044203:anti-IgM