Title
Prothrombotic factors in histologically proven nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
Author
Faculty/Department
Faculty of Medicine and Health Sciences
University Hospital Antwerp
Publication type
article
Publication
Baltimore, Md ,
Subject
Human medicine
Source (journal)
Hepatology / American Association for the Study of Liver Diseases. - Baltimore, Md
Volume/pages
59(2014) :1 , p. 121-129
ISSN
0270-9139
ISI
000328738400016
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
An independent role of nonalcoholic fatty liver disease (NAFLD) in the development of cardiovascular disease has been suggested, probably mediated through increased levels of prothrombotic factors. Therefore, we examined whether NAFLD is linked to a prothrombotic state, independently of metabolic risk factors in a large single-center cohort of overweight/obese patients. Patients presenting to the obesity clinic underwent a detailed metabolic and liver assessment, including an extensive panel of coagulation factors. If NAFLD was suspected, a liver biopsy was proposed. A series of 273 consecutive patients (65% female) with a liver biopsy were included (age, 44 +/- 0.76 years; body mass index: 39.6 +/- 0.40 kg/m(2)). Increase in fibrinogen, factor VIII, and von Willebrand factor and decrease in antithrombin III correlated with metabolic features, but not with liver histology. Levels of plasminogen activator inhibitor-1 (PAI-1) increased significantly with increasing severity of steatosis (P<0.001), lobular inflammation (P<0.001), ballooning (P=0.002), and fibrosis (P<0.001). Patients with nonalcoholic steatohepatitis had significantly higher PAI-1 values than those with normal liver (P<0.001). In multiple regression, including anthropometric and metabolic parameters, steatosis remained an independent predictor of PAI-1 levels, explaining, together with fasting C-peptide and waist circumference, 21% of the variance in PAI-1. No consistent correlations with histology were found for the other coagulation factors. Conclusion: In obesity, NAFLD severity independently contributes to the increase in PAI-1 levels, whereas other coagulation factors are unaltered. This finding might, in part, explain the increased cardiovascular risk associated with NAFLD. (Hepatology 2014;58:121-129)
E-info
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