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Association between thrombotic risk factors and extent of fibrosis in patients with non-alcoholic fatty liver diseases

查看全文 作　　者：N [1]Assy;I [2]Bekirov;Y [2]Mejritsky;L [3]Solomon;S [4]Szvalb;O [1]Hussein 高影响力作者 机构地区：[1]Liver Unit and Internal Medicine A Sieff Hospital, Safed, Israel Technion Faculty of Medicine, Haifa, Israel;[2]Liver Unit and Internal Medicine B Sieff Hospital, Safed, Israel;[3]Department of HematologySieff Hospital, Safed,Israel;[4]Department of PathologySieff Hospital, Safed, Israel高影响力机构 出　　处：《World Journal of Gastroenterology》索引2005年第11卷第37期,共6页高影响力期刊 摘　　要：AIM: To evaluate the prevalence of genetic and acquired prothrombotic risk factors and their association with the extent of fibrosis and fatty infiltration in patients with non-alcoholic fatty liver disease (NAFLD).METHODS: Forty-four patients with chronic hepatitis (28 men and 16 women, with mean age of 45±11 and 49±12 years, respectively) constituted the patient population of this study. The groups were divided as follows: 15 patients with fatty liver (FL); 15 with non-alcoholic steatohepatitis (NASH); 14 with chronic viral hepatitis (CH) diagnosed by histology and liver technetium scan or ultrasound; and 10 healthy individuals. Thrombophilic, coagulation factors and genetic mutations were diagnosed by standard hemostatic and molecular coagulation assays.RESULTS: Activated protein C (APC) resistance and protein S were the most prevalent thrombotic risk factors (6% and 10% in NAFLD vs 21% and 14% in CH; P<0.01 and P<0.05, respectively). One thrombotic risk factor was identified in 41% of patients (23% mild fibrosis, 18% severe fibrosis) and two thrombotic risk factors in 6% of patients with NAFLD and severe fibrosis. While no differences in APC ratio, lupus anticoagulant, fibrinogen, factor V Leiden,prothrombin, and MTHFR mutation were found. Protein S levels were significantly lower in NASH patients than in patients with FL alone (92±19 vs106±2, P<0.01). Protein C levels were markedly higher in patients with NAFLD and mild or severe fibrosis as compared to the patients with CH, respectively (128±40 vs96±14, P<0.001 or 129±36 vs 88±13, P<0.01).CONCLUSION: Up to 46% of patients with NAFLD may have thrombotic risk factors, and the presence of thrombotic risk factors is correlated with the extent of hepatic fibrosis,suggesting a crucial role of the coagulation system in the pathogenesis of hepatic fibrosis. 关 键 词：血栓形成 纤维症 非酒精依赖性脂肪肝 病理机制
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