Comorbidities associated with higher von Willebrand factor (VWF) levels may explain the age-related increase of VWF in von Willebrand disease.
Br J Haematol
; 182(1): 93-105, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29767844
ABSTRACT
Some comorbidities, such as hypertension, are associated with higher von Willebrand factor (VWF) levels in the general population. No studies have been conducted to assess this association in patients with von Willebrand disease (VWD). Therefore, we studied this association in patients with type 1 (n = 333) and type 2 (n = 203) VWD from the 'WiN" study. VWF antigen (VWFAg) was higher in type 1 VWD patients with hypertension [difference 0·23 iu/ml, 95% confidence interval (CI) 0·11-0·35], diabetes mellitus (0·11 iu/ml, 95% CI -0·02 to 0·23), cancer (0·14 iu/ml, 95% CI 0·03-0·25) and thyroid dysfunction (0·14 iu/ml, 95% CI 0·03-0·26) than in patients without these comorbidities (all corrected for age, sex and blood group). Similar results were observed for VWF collagen binding capacity (VWFCB), VWF activity as measured by the VWF monoclonal antibody assay (VWFAb) and factor VIII (FVIII) coagulant activity (FVIIIC). In type 1 VWD, age was associated with higher VWFAg (0·03 iu/ml; 95% CI 0·01-0·04), VWFCB (0·02 iu/ml; 95% CI 0·00-0·04), VWFAb (0·04 iu/ml; 95% CI 0·02-0·06) and FVIIIC (0·03 iu/ml; 95% CI 0·01-0·06) per decade increase. After adjustment for relevant comorbidities, these associations were no longer significant. Despite the higher VWF and FVIII levels, type 1 VWD patients with comorbidities had more bleeding episodes, particularly during surgery. There was no association between comorbidities and VWF/FVIII levels or bleeding phenotype in type 2 VWD patients. In conclusion, comorbidities are associated with higher VWF and FVIII levels in type 1 VWD and may explain the age-related increase of VWF and FVIII levels.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças de von Willebrand
/
Envelhecimento
/
Fator de von Willebrand
Tipo de estudo:
Observational_studies
/
Prevalence_studies
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Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
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Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Br J Haematol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Holanda