The study on the correlation between DVT occurrence and F12 gene polymorphism in fracture patients
10.3760/cma.j.cn121113-20240511-00285
- VernacularTitle:骨折后下肢深静脉血栓形成与 F12基因多态性的相关性研究
- Author:
Jiacheng ZANG
1
;
Shuang YANG
1
;
Yinguang ZHANG
1
;
Xinlong MA
1
Author Information
1. 天津市天津医院髋关节外科,天津 300211
- Publication Type:Journal Article
- Keywords:
Fracture;
Venous thrombosis;
Factor XII;
Sequence analysis, DNA;
Comparative study
- From:
Chinese Journal of Orthopaedics
2024;44(24):1611-1618
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationships among the activity level of coagulation factor XII (FXII), coagulation function indexes, polymorphisms of F12 gene loci rs17876030 and rs1801020, as well as their correlations with deep venous thrombosis (DVT) in fracture patients. Methods:A case-cohort control study was conducted. 200 fracture patients diagnosed and treated in the Department of Traumatic Orthopedics of Tianjin Hospital from September 2015 to September 2023 were included. They received routine anticoagulant prophylaxis for DVT treatment but still developed DVT during hospitalization (thrombus group). 100 fracture patients hospitalized during the same period without DVT under the same anticoagulant strategy were matched (non-thrombus group). 100 healthy people who underwent physical examinations in the outpatient department of Tianjin Hospital during the same period were also matched (normal group). Plasma samples of all subjects were collected. Laboratory tests were performed to measure activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), D-Dimer. The activity level of FXII was detected by the one-stage fixation method, the antigen of FXII was detected by enzyme-linked immunosorbent assay, and the polymorphisms of F12 gene loci rs17876030 and rs1801020 were detected by direct sequencing method. The relationships among various detection indexes and their correlations with DVT were analyzed. Results:There were no statistically significant differences in APTT, PT, and TT among the thrombus group, non-thrombus group, and normal group ( F=0.748, P=0.483; F=0.092, P=0.840; F=0.031, P=0.660). The Fg in the thrombus group was 4.5±2.4 g/L and D-Dimer was 786.2±234.9 mg/L, which were statistically different from 2.9±1.8 g/L and 261.3±165.5 mg/L in the non-thrombus group and 2.2±1.1 g/L and 198.1±96.4 mg/L in the normal group respectively ( F=3.473, P=0.046; F=34.960, P<0.001; P<0.05). The activity of FⅫ in the thrombus group was 78.3%±21.9%, which was statistically different from 97.8%±31.4% in the non-thrombus group and 94.5%±35.7% in the normal group ( F=3.581, P=0.032; P<0.05). The activity of FXII was negatively correlated with APTT ( r=-0.149, P=0.035). In the thrombus group, there were 122 cases (61.0%) with the TT genotype of rs17876030, which was statistically different from 34 cases (34.0%) in the non-thrombus group and 30 cases (30.0%) in the normal group (χ 2=12.630, P=0.002). In the thrombus group, there were 115 cases (57.5%) with the CC genotype of rs1801020, which was statistically different from 25 cases (25.0%) in the non-thrombus group and 16 cases (16.0%) in the normal group (χ 2=26.820, P<0.001). The activity levels of FXII of the TT genotype of rs17876030 in the thrombus group, non-thrombus group, and normal group were lower than those of the CC and CT genotypes, and the differences were statistically significant ( F=27.130, P<0.001; F=18.384, P<0.001; F=12.830, P=0.001; P<0.05). The activity levels of FXII of the CC genotype of rs1801020 in the three groups were lower than those of the TT and CT genotypes, and the differences were statistically significant ( F=38.631, P<0.001; F=23.562, P<0.001; F=25.829, P<0.001; P<0.05). The proportion of the TT genotype of rs17876030 was the highest in the thrombus group, and the activity level of FⅫ in patients with this genotype was lower. The TT genotype of rs17876030 was related to DVT ( r=-0.831, P=0.043). The proportion of the CC genotype of rs1801020 was the highest in the thrombus group, and the activity level of FⅫ in patients with this genotype was lower. The CC genotype of rs1801020 was related to DVT ( r=-0.784, P=0.040). Conclusion:Fg and D-Dimer are related to DVT. The activity level of FXII is negatively correlated with APTT. Prolonged APTT suggests the possibility of FⅫ deficiency, and the decreased activity level of FXII may be related to DVT.