Abstract Number: PB1527
Meeting: ISTH 2020 Congress
Theme: Platelet Disorders and von Willebrand Disease » von Willebrand Factor Biology
Background: Factor VIII (FVIII:C) and von Willebrand Factor antigen (VWF:ag) levels increase with age in the general population.
Aims: To evaluate whether the increase of FVIII:C and VWF:Ag with age in the population is mediated by estrogen use, body mass index (BMI), comorbidities, impaired kidney function, or high levels of C reactive protein (CRP).
Methods: Analyses were performed in a sample from the general population in the Netherlands (n=2823; table 1). Individuals with active cancer and women who were pregnant or within three months postpartum were excluded. FVIII:C was measured on an automatic coagulometer (STA-R) and VWF:Ag with an immunoturbidimetric method (STA Liatest), according to the manufactures instructions. Estimated glomerular filtration rate (eGFR) was calculated by the MDRD equation. Information on estrogen use, BMI, and comorbidities (diabetes, liver and kidney disease, rheumatoid arthritis, multiple sclerosis, hyperthyroidism, hypothyroidism, bronchitis, emphysema, heart failure, angina, myocardial infarction, transient ischemic attack, ischemic and hemorrhagic stroke, peripheral vascular disease) was obtained from self-administered questionnaires. Linear regression analysis was used to evaluate the change in FVIII:C and VWF:Ag levels with age. Analyses were adjusted for sex, estrogen use, BMI, comorbidities, CRP (log transformed), and eGFR.
Results: FVIII:C and VWF:Ag increased with age , i.e., increase per decade of age (β) for FVIII:C: 8 IU/dL, 95%CI 7-9 and for VWF:Ag: 11 IU/dL, 95%CI 10-13. Adjustment for eGFR led to marginally different estimates: FVIII:C: β 7 IU/dL, 95%CI 6-8, VWF:Ag: 10 IU/dL, 95%CI 8-11. Further adjustment for sex, estrogen use, BMI, comorbidities, and CRP (individually or in the full model) did not affect the association between biomarkers and age (full model: FVIII:C: β 5 IU/dL, 95%CI 4-7, VWF:Ag: 8 IU/dL, 95%CI 6-9). Table 2 shows FVIII:C and VWF:Ag in age groups.
Conclusions: The increase of FVIII:C and VWF:Ag with age is only marginally mediated by estrogen use, BMI, comorbidities, eGFR, or CRP.
| Population controls (n=2823) | |
| Male, n (%) | 1364 (48) |
| Age at enrollment (years), mean (SD) | 49 (12) |
| Major illness, n (%) | 444 (16) |
| Estrogen use (in women), n (%) | 425 (31) |
| BMI (kg/m2), mean (SD) | 25.60 (4) |
| C reactive protein (mg/L), mean (SD) | 2.83 (5.68) |
| eGRF (mL/min), mean (SD) | 87 (17) |
| FVIII activity (IU/dL), mean (SD) | 112 (38) |
| VWF antigen (IU/dL), mean (SD) | 112 (47) |
[Table 1. Clinical characteristics.]
| Age (years | Number of controls, n (%) | Mean FVIII (IU/dL) | FVIII Mean difference (IU/dL) | Adjusted# FVIII Mean difference (IU/dL) | Mean VWF:Ag (IU/dL) | VWF:Ag Mean difference (IU/dL) | Adjusted# VWF:Ag Mean difference (IU/dL) |
| 18-30 | 223 (8) | 101 (35) | Reference | Reference | 97 (35) | Reference | Reference |
| 30-40 | 480 (17) | 101 (32) | 0 (-6 to5) |
-2 (-8 to 3) |
97 (34) | 2 (-5 to 8) |
-1 (-9 to 6) |
| 40-50 | 677 (24) | 105 (35) | 4 (-2 to 9) |
0 (-6 to 5) |
101 (36) | 5 (-1 to 11) |
0 (-7 to 7) |
| 50-60 | 847 (30) | 114 (36) | 13 (8 to 18) |
5 (0 to 11) |
115 (43) | 19 (13 to 26) |
10 (3 to 16) |
| 60-70 | 596 (21) | 129 (43) | 27 (22 to 33) |
18 (11to 24) |
136 (62) | 39 (33 to 46) |
27 (20 to 35) |
| #adjusted for sex, estrogen use, BMI, comorbidities, CRP and eGFR | |||||||
[Table 2. FVIII activity and VWF antigen levels in age groups.]
To cite this abstract in AMA style:
Biguzzi E, Castelli F, Lijfering WM, Cannegieter SC, Eikenboom J, Rosendaal FR, van Hylckama Vlieg A. Explanations for Rise of Levels of Factor VIII and von Willebrand Factor Antigen with Age [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/explanations-for-rise-of-levels-of-factor-viii-and-von-willebrand-factor-antigen-with-age/. Accessed October 1, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/explanations-for-rise-of-levels-of-factor-viii-and-von-willebrand-factor-antigen-with-age/