Normal ranges and genetic variants of antithrombin, protein C and protein S in the general Chinese population. Results of the Chinese Hemostasis Investigation on Natural Anticoagulants Study I Group
Open Access
- 12 April 2011
- journal article
- Published by Ferrata Storti Foundation (Haematologica) in Haematologica
- Vol. 96 (7), 1033-1040
- https://doi.org/10.3324/haematol.2010.037515
Abstract
Background Inherited deficiency of antithrombin, protein C and protein S, three important, naturally occurring coagulation inhibitors, might play a major role in the occurrence of venous thromboembolism in Chinese. The establishment of age- and gender-related normal ranges of these inhibitors is crucial for an accurate diagnosis of these deficiencies. Design and Methods We designed a prospective cross-sectional study recruiting healthy adults from four university–affiliated hospitals in China. Antithrombin, protein C and protein S were studied by measuring their activity. Gene analysis was performed when natural anticoagulant deficiency was suspected. Polymorphisms of the factor V gene were searched for among subjects who were positive for activated protein C resistance. Results In 3493 healthy Chinese adults (1734 men, 1759 women; age 17–83 years), we found higher age-adjusted activities for protein C and protein S in men than in women but no sex difference for antithrombin. In women, mean protein C and protein S activities increased with age. In men, mean protein C levels increased with age up to the age of 49 but decreased after 50 years old; mean protein S levels decreased after 50 years of age. Antithrombin levels remained stable over time in women but decreased significantly after 50 years of age in men. Reference values according to age and sex allowed the identification of 15 genetic variants (protein C: 10, antithrombin: 3, protein S: 2) in subjects with protein activity below the 1st percentile. Conclusions This is the largest survey ever conducted in the healthy general Chinese population. These normal ranges provide the essential basis for the diagnosis and treatment of thrombosis in Chinese.This publication has 48 references indexed in Scilit:
- Prevalence of protein S deficiency in the Japanese general population: The Suita StudyJournal of Thrombosis and Haemostasis, 2004
- Pulmonary thromboembolism in Asians/Pacific Islanders in the United States: analysis of data from the National Hospital Discharge Survey and the United States Bureau of the CensusAmerican Journal Of Medicine, 2004
- Protein C and antithrombin deficiency are important risk factors for deep vein thrombosis in JapaneseJournal of Thrombosis and Haemostasis, 2004
- No association between thrombosis and factor V gene polymorphisms in Chinese Han populationThrombosis and Haemostasis, 2003
- A review of the technical, diagnostic, and epidemiologic considerations for protein S assays.Archives of Pathology & Laboratory Medicine, 2002
- Deep vein thrombosis is not rare in Asia--the Singapore General Hospital experience.2002
- An Extremely Low Prevalence of Factor V Leiden, FIIG20210A and FXIIIV34L in Taiwan Chinese PopulationThrombosis and Haemostasis, 2002
- Frequency of natural coagulation inhibitor (antithrombin III, protein C and protein S) deficiencies in Japanese patients with spontaneous deep vein thrombosisBlood Coagulation & Fibrinolysis, 2001
- A comparison of polymorphism in the 3'-untranslated region of the prothrombin gene between Chinese and Caucasians in AustraliaBritish Journal of Haematology, 2000
- Absence of Thrombosis in Subjects with Heterozygous Protein C DeficiencyNew England Journal of Medicine, 1987