Altered clot kinetics in patients with non-alcoholic fatty liver disease.
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.
Hickman
Ingrid J
IJ
The Diamantina Institute for Cancer, Immunology and Metabolic Medicine, The University of Queensland, Australia. i.hickman@uq.edu.au
Sullivan
Clair M
CM
Flight
Simone
S
Campbell
Catherine
C
Crawford
Darrell H
DH
Masci
Paul P
PP
O'Moore-Sullivan
Trisha M
TM
Prins
Johannes B
JB
Macdonald
Graeme A
GA
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