Articles |
From the Department of Internal Medicine II, Cardiology, University of Ulm Medical Center, and the GSFNational Research Center for Environment and Health, MEDIS Institute, Neuherberg (M.S.), Germany.
Correspondence to Dr Margit Fröhlich, Abteilung Innere Medizin II, Universität Ulm, Robert-Koch-Straße 8, D-89081 Ulm, Germany.
Abstract The incidence of cardiovascular
diseases is increased in winter months. Recent studies have shown
seasonal changes in plasma viscosity, fibrinogen, and factor VII
activity with elevated levels during winter. An increase in these
factors generates a "hypercoagulable state," which may lead to a
rise in cardiovascular morbidity and mortality. It has
been suggested that an increase in upper respiratory infections might
be the underlying cause for the raised acute-phase reactants, in
particular fibrinogen, during the winter season. We investigated
seasonal variations of 26 parameters, determining blood
rheology and hemostasis in 16 healthy volunteers (8 men and 8
women) aged 20 to 41 years. They were seen at monthly intervals over a
period of 1 year. Seasonal variation with peak fitted values in the
winter months was found for plasma viscosity (P<.001 for
the seasonal difference), red blood cell deformability
(P<.001), whole blood viscosity (P<.001),
hemoglobin (P<.001), hematocrit (P<.001), mean
corpuscular volume (P=.001), platelet count
(P=.01),
1-glycoprotein (P<.001),
fibrinogen (measured by immunonephelometry; P<.001),
plasminogen activator inhibitor-1
(P=.002), LDL cholesterol (P=.003),
and triglyceride levels (P<.001). HDL
cholesterol (P<.001) and cortisol
(P=.001) showed inverse seasonal patterns, with a maximum
during summertime. No statistically significant seasonal variations
were seen for red blood cell aggregation, complement factor C4, total
cholesterol, ceruloplasmin, haptoglobin, white blood
cell count, and plasminogen. These data do not support the
hypothesis that increased morbidity and mortality from
cardiovascular diseases during winter may be mainly
attributable to increased synthesis of acute-phase proteins due to
infections. The cause for the seasonal variations in rheological and
hemostatic parameters remains unclear and should be studied
in more detail.
Key Words: seasonal variation hemostatic parameters blood rheology acute-phase reactants healthy young adults
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