Distribution of antiphospholipid antibodies in a large population-based German cohort
-
Davit Manukyan
Abstract
Background:
Antiphospholipid syndrome (APS) is the most common acquired thrombophilia. Diagnosis is based on clinical criteria and the presence of antiphospholipid antibodies (aPLs) above the 99th percentile of a reference group. Data on the distribution of aPL in the population are limited. The distribution of aPL including diagnostic cutoffs should be determined in a population-based cohort.
Methods:
The Gutenberg Health Study (GHS) is a population-based cohort aged 35–74 years. We determined the presence of antibodies against cardiolipin (aCL, IgG, and IgM), β2-glycoprotein I (anti-β2GPI, IgG, and IgM), and domain 1 of β2-glycoprotein I (anti-domain 1, IgG) in a sample of 4979 participants.
Results:
aPL titers were similar in the whole sample and in an apparently healthy subgroup of 1049 individuals. There was a strong age-dependent increase of both aCL and anti-β2GPI IgM, while aPL IgG titers were stable or tended to decrease with age. A relevant decrease was observed for aCL IgG in women and anti-domain 1 IgG in both sexes. There was no association of aPL titers with a history of venous thromboembolism (VTE).
Conclusions:
Our data show that for IgM aPL, age-dependent reference ranges should be used. In fact, the controversy regarding the clinical utility of IgM aPL might be related to the use of inappropriate reference ranges among other causes. In our population, aPLs were not associated with a history of VTE.
Acknowledgments
The competent technical assistance of Martina Hermanns is gratefully acknowledged.
Author contributions: D. Manukyan designed the study, performed research, and analyzed data; H. Rossmann performed research and analyzed data; A. Schulz performed statistical analysis; T. Zeller designed the cohort study; N. Pfeiffer designed the cohort study; H. Binder analyzed data and critically discussed data; T. Münzel designed the cohort study; M.E. Beutel designed the cohort study; N. Müller-Calleja designed the study and critically discussed data; P. Wild designed and coordinated the cohort study; and K.J. Lackner designed the cohort study and the actual analysis, and wrote the article. All the authors approved the final version of the article submitted for publication. All the authors have accepted responsibility for the entire content of this submitted article and approved submission.
Research funding: This study was supported by a grant of the Foundation for Pathobiochemistry and Molecular Diagnostics of the Deutsche Vereinte Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL). The GHS is funded through the Government of Rhineland-Palatinate (“Stiftung Rheinland-Pfalz für Innovation”, contract AZ 961-386261/733), the research programs “Wissen schafft Zukunft” and “Center for Translational Vascular Biology (CTVB)” of the Johannes Gutenberg-University of Mainz, and its contract with Boehringer Ingelheim and PHILIPS Medical Systems, including an unrestricted grant for the GHS.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplemental Material:
The online version of this article (DOI: 10.1515/cclm-2016-0014) offers supplementary material, available to authorized users.
©2016 Walter de Gruyter GmbH, Berlin/Boston
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