title: Hypercoagulation and thrombophilia in nonalcoholic fatty liver disease: mechanisms, human evidence, therapeutic implications, and preventive implications.
abstract: Nonalcoholic fatty liver disease (NAFLD) is a spectrum of disorders with a high prevalence in the industrialized world. Despite the high prevalence, the etiology and fundamental pathophysiology for the disease process is poorly understood. There is now a growing fund of knowledge suggesting that the ongoing inflammatory state associated with NAFLD leads to a low-level activation of the coagulation system. Although the data supporting this activation of the coagulation system are significant, the link with end-organ disease, mainly cardiovascular disease, is less firm and mostly epidemiological. In this review, we will explore the evidence for and against a hypercoagulable or thrombophilic state in NAFLD. We will examine possible pathophysiologic explanations and mechanisms, human epidemiologic and population-based data, and the possible therapeutic and preventative implications for treatment of thrombophilia in patients with this disease process.
authors.affiliation: Coagulation in Liver Disease Study Group, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, Virginia, USA. pgn5qs@virginia.edu
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Northup
authors.forename: Curtis K
authors.initials: CK
authors.lastname: Argo
authors.forename: Neeral
authors.initials: N
authors.lastname: Shah
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Caldwell
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D005234:Fatty Liver / Q000150:complications*; D006505:Hepatitis / Q000150:complications*; D006801:Humans; D065626:Non-alcoholic Fatty Liver Disease; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019851:Thrombophilia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors