title: Altered clot kinetics in patients with non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Emerging evidence has linked the presence of non-alcoholic fatty liver disease (NAFLD) with an increased risk for cardiovascular events. We hypothesised that altered clot kinetics and platelet function may contribute to this increased risk. This study compared whole blood clotting kinetics in patients with 1) non-cirrhotic NAFLD (n = 28) and 2) healthy control subjects (n = 22).
  
  
  METHODS
  Clotting kinetics were assessed in whole blood using thromboelastography (TEG) and assessed for correlations with cardiovascular risk factors.
  
  
  RESULTS
  Clot kinetics in patients with NAFLD showed significantly stronger clot development (maximum amplitude (MA); 58.3 +/- 6.3 mm vs. 52.0 +/- 10.1 mm, p = 0.01) and reduced clot lysis in the presence of thrombin (35 +/- 30% vs. 51 +/- 26% clot lysis 30 minutes after MA, p = 0.03) compared to control subjects. Clot strength was independently positively associated with body mass index in NAFLD, but not in control subjects. There was a greater platelet contribution to clot strength in patients with NAFLD compared to controls despite similar platelet counts. There was no association between clot kinetics and features of the metabolic syndrome or presence of type 2 diabetes.
  
  
  CONCLUSIONS
  Patients with NAFLD have disturbances in ex-vivo clot kinetics including increased clot strength and clots that are more resistant to thrombin-stimulated lysis.
authors.affiliation: The Diamantina Institute for Cancer, Immunology and Metabolic Medicine, The University of Queensland, Australia. i.hickman@uq.edu.au
authors.forename: Ingrid J
authors.initials: IJ
authors.lastname: Hickman
authors.forename: Clair M
authors.initials: CM
authors.lastname: Sullivan
authors.forename: Simone
authors.initials: S
authors.lastname: Flight
authors.forename: Catherine
authors.initials: C
authors.lastname: Campbell
authors.forename: Darrell H
authors.initials: DH
authors.lastname: Crawford
authors.forename: Paul P
authors.initials: PP
authors.lastname: Masci
authors.forename: Trisha M
authors.initials: TM
authors.lastname: O'Moore-Sullivan
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Prins
authors.forename: Graeme A
authors.initials: GA
authors.lastname: Macdonald
mesh_terms: D000328:Adult; D001706:Biopsy; D001777:Blood Coagulation / Q000502:physiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D005234:Fatty Liver / Q000097:blood* / Q000150:complications*; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D012307:Risk Factors; D013916:Thrombelastography