Circadian rhythms of fibrinogen antithrombin III and plasminogen in chronic liver diseases of increasing severity.
Acquired deficiencies of fibrinogen, antithrombin III and plasminogen are reported in liver disease, and it is known that their plasma levels fluctuate during the day. The aim of this study was to investigate the circadian rhythms of these three factors in chronic liver disease. Five groups of subjects were considered: (A) 15 healthy controls: (B) 15 patients with hepatic alcoholic steatosis; (C) 15 patients with chronic active hepatitis; (D) 15 patients with compensated cirrhosis of the liver, and (E) 15 patients with decompensated cirrhosis with ascites. The levels of fibrinogen, antithrombin III and plasminogen were determined in blood samples drawn in each subject during the span of a day every 3 h starting from midnight. The time-related values were analyzed using the 'population-mean cosinor' method. Groups A and B presented a significant (p < 0.05) circadian rhythm for each variable, group C a significant (p < 0.05) circadian rhythm for fibrinogen and antithrombin III and groups D and E no significant (p > 0.05) circadian rhythms. Statistically significant differences (p < 0.05) were demonstrated among the groups in the mean daily levels of the three variables by ANOVA, the concentrations decreasing with disease severity. These data confirm the existence of a significant diurnal periodicity in the circulating levels of fibrinogen, antithrombin III and plasminogen in controls and suggest that liver disease is associated with progressive circadian modifications in the temporal structure of fibrinogen, antithrombin III and plasminogen, related to the stage of the liver disease. The rhythm derangements may be considered markers of evolution in liver disease.
Pasqualetti
P
P
Department of Internal Medicine and Public Health, School of Medicine and Surgery, University of L'Aquila, Italy.
Festuccia
V
V
Acitelli
P
P
Natali
L
L
Collacciani
A
A
Casale
R
R
D000328:Adult; D000990:Antithrombin III / Q000378:metabolism*; D002908:Chronic Disease; D002940:Circadian Rhythm; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D008107:Liver Diseases / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010958:Plasminogen / Q000378:metabolism*
D000990:Antithrombin III; D005340:Fibrinogen; D010958:Plasminogen