Abstract-Factor (F) XIII covalently cross-links and stabilizes the fibrin-clot. Recent evidence suggests a role for FXIII in atherothrombotic diseases, but no information is available regarding the association of FXIII with common risk factors. The aim of this study was to investigate the relationship of FXIII with age, sex, smoking, and hypertension. Plasma levels of FXIII A-subunit antigen, FXIII B-subunit antigen, and FXIII cross-linking activity were measured in 612 healthy individuals (250 men and 362 women). FXIII A-and B-subunit levels were correlated significantly with age in both men (rϭ0.21, Pϭ0.001, and rϭ0.17, Pϭ0.008, respectively) and women (rϭ0.20, PϽ0.0005, and rϭ0.13, Pϭ0.011, respectively Key Words: factor XIII Ⅲ sex Ⅲ age Ⅲ smoking Ⅲ hypertension T he transglutaminase blood coagulation factor XIII (FXIII) covalently cross-links and therefore stabilizes the fibrin clot, which initially is held together solely by electrostatic interactions. 1,2 The mature proenzyme circulates as a tetramer consisting of 2 A-subunits containing the active site and 2 B-subunits serving as carriers of the A-subunits in plasma. In addition to introducing peptide bonds between aligned fibrin ␣-and ␥-chains, FXIII incorporates ␣ 2 -antiplasmin, 3,4 von Willebrand factor, 5 thrombospondin, 6 and fibronectin 7,8 into the fibrin network. Through these crosslinking reactions, the mechanical, chemical, and proteolytic vulnerability of the fibrin clot is decreased by FXIII. Because a deficiency of FXIII leads to severe bleeding, the critical role of FXIII in blood clotting has long been acknowledged. The involvement of FXIII in thrombotic disease is instead starting to emerge only now. It has been shown that FXIII levels were increased in non-insulin-dependent diabetic patients with microangiopathy and macroangiopathy 9 and in patients with obliterative atherosclerosis of the lower limbs. 10 Increased cross-linking of fibrin ␥-chains has been found in patients with acute myocardial infarction. 11 In addition, plasma samples from men with myocardial infarction at a young age formed fibrin gel structures that were more tight and rigid than did plasma samples from normal subjects. 12 Recently, we have shown that a common genetic polymorphism in the FXIII A-subunit, coding for a substitution of valine with leucine at residue 34, is protective against myocardial infarction. 13 These studies suggest that FXIII may be a risk factor for the development of atherothrombotic disorders. To date, there is no information available regarding the relation of FXIII with other known risk factors of cardiovascular disease, such as age and smoking. The aim of the present study was to investigate the influence of sex, age, smoking, and hypertension on FXIII activity and subunit antigen levels in a population of healthy individuals.
Methods
SubjectsPlasma samples were obtained from 612 healthy, white northern Europeans, 250 men and 362 women, aged between 22 and 93 years.