Serum phospholipids are the main environmental determinants of activated factor VII in the most common FVII genotype

Background and Objective. Numerous studies have emphasized the role of trig lyceride-rich lipoproteins and of Factor VII (FVII) polymorphisms in determ ining levels of FVII activity. Design and Methods. This study was undertaken to evaluate the role of other lipid fractions and the interaction between lipids and FVII in subjects wi th recognised genotypes. Volunteer subjects (n=459) from 5 European countri es were studied. Blood samples were drawn Irrespective of the time of day o r fasting status. Levels of FVII activity (FVIIc), activated Evil (FVIIa) a nd Evil antigen (FVIIAg) were evaluated with reference to a number of lipid parameters (HDL-, LDL- and total cholesterol, triglycerides, phospholipids , lipoprotein(a), and apoliproptein Al). The two most common FVII polymorph isms were analyzed in combination (353R/Q and 5'F7; alleles M1/M2 and A1/A2 , respectively). Results. Homozygotes for the Al and M1 alleles (M11/A11) had significantly higher FVII levels. At multiple regression analysis the strongest predictor of FVIIa and FVIIc was the concentration of phospholipids. This interactio n was confined to the A11M11 genotype subjects. Interpretation and Conclusions. These data indicate that lipids contribute mainly to FVIIa levels through their phospholipid content, and that the deg ree of this contribution is strictly dependent on FVII genotypes. (C) 1999, Ferrata Storti Foundation.