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. 2024 Nov-Dec;18(6):e1002-e1014.
doi: 10.1016/j.jacl.2024.08.004. Epub 2024 Aug 12.

Fibrinogen and plasma clot properties are associated with apolipoprotein B and apolipoprotein B-containing lipoproteins in Africans

Daniel Bruwer  1 , Zelda de Lange-Loots  2 , Marlys L Koschinsky  3 , Michael B Boffa  4 , Marlien Pieters  5
Affiliations
Free article

Fibrinogen and plasma clot properties are associated with apolipoprotein B and apolipoprotein B-containing lipoproteins in Africans

Daniel Bruwer et al. J Clin Lipidol. 2024 Nov-Dec.
Free article

Abstract

Background: Case-control, intervention and laboratory studies have demonstrated a link between apolipoprotein B (ApoB)-containing lipoproteins and clot structure and thrombosis. There is, however, limited evidence on a population level.

Objectives: We determined the cross-sectional relationship between lipoprotein(a) [Lp(a)], low-density lipoprotein cholesterol (LDL-C), and ApoB with fibrinogen and plasma clot properties in 1462 Black South Africans, a population with higher fibrinogen and Lp(a) levels compared with individuals of European descent.

Methods: Data were obtained from participants in the South African arm of the Prospective Urban and Rural Epidemiology study. Clot properties analyzed included lag time, slope, maximum absorbance, and clot lysis time (turbidity). Lp(a) was measured in nM using particle-enhanced immunoturbidimetry. General linear models (GLM) were used to determine the associations between ApoB and ApoB-containing lipoproteins with fibrinogen and plasma clot properties. Stepwise regression was used to determine contributors to clot properties and Lp(a) variance.

Results: GLM and regression results combined, indicated fibrinogen concentration and rate of clot formation (slope) had the strongest association with Lp(a); clot density associated positively with both Lp(a) and LDL-C; time to clot formation associated negatively with ApoB; and clot lysis time (CLT) demonstrated strong positive associations with both ApoB and LDL-C, while its association with Lp(a) was fibrinogen concentration dependent.

Conclusion: These findings suggest that ApoB and the lipoproteins carrying it contribute to prothrombotic clot properties in Africans on an epidemiological level and highlight potential novel prothrombotic roles for these (apo)lipoproteins to be considered for the development of targeted therapeutic approaches to address thrombotic conditions related to clot properties.

Keywords: African; Apolipoprotein B; Fibrinogen; Fibrinolysis; Lipoprotein(a).

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: This work was supported by the North-West University, South African National Research Foundation, Population Health Research Institute, and the South African Medical Research Council (SAMRC-RFA-EMU-1-0-2020). None of the funding bodies was involved in the design of the study, collection, analysis, or interpretation of the data or in writing of this manuscript. Opinions expressed and conclusions arrived at are those of the authors and are not to be attributed to the funding sources.

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