Ann Lab Med.  2015 Jan;35(1):15-21. 10.3343/alm.2015.35.1.15.

Influence of Blood Lipids on Global Coagulation Test Results

Affiliations
  • 1Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea. lukekhk@snu.ac.kr
  • 2Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
High levels of blood lipids have been associated with high levels of coagulation factors. We investigated whether blood lipids influence the results of global coagulation tests, including prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin generation assay (TGA).
METHODS
PT, aPTT, and TGA, along with procoagulant and anticoagulant factors, were measured in 488 normal individuals. Vitamin K status was assessed with prothrombin-induced by vitamin K absence-II (PIVKA-II).
RESULTS
The procoagulant factors II, VII, IX, X, and XI and anticoagulant factors protein C and protein S showed significant correlations with triglyceride, and the procoagulant factors II, V, VII, IX, X, XI, and XII and anticoagulant factors antithrombin and protein C correlated with total cholesterol. There were no correlations of blood lipid levels with PIVKA-II levels. Subjects with high triglyceride levels (> or =200 mg/dL) showed shorter PT values than those with lower triglyceride levels. However, aPTT value was not changed in terms of blood lipid levels. In both 1 and 5 pM tissue factor-induced TGAs, subjects in the high-triglyceride or high-cholesterol groups (> or =240 mg/dL) had high levels of lag time, time-to-peak, and endogenous thrombin potential. Total cholesterol was a significant determinant of PT and TGA values.
CONCLUSION
High blood lipids were related with increased coagulation activity in a normal population. Our findings are expected to help interpret the global coagulation test results in individuals with high lipid levels.

Keyword

Blood coagulation tests; Triglycerides; Cholesterol; Blood coagulation factors

MeSH Terms

Adult
Aged
Blood Coagulation Factors/metabolism
*Blood Coagulation Tests
Cholesterol/blood
Female
Humans
Linear Models
Lipids/*blood
Male
Middle Aged
Partial Thromboplastin Time
Prothrombin Time
Reproducibility of Results
Thrombin/metabolism
Triglycerides/blood
Blood Coagulation Factors
Cholesterol
Lipids
Thrombin
Triglycerides

Figure

  • Fig. 1 Parameters of thrombin generation assay. Tissue factor addition generates thrombin along the reaction time, and the resulting thrombin generation curve can be drawn as the above bell-shaped curve. Lag time is the point at which one-sixth of the peak thrombin height is reached; time-to-peak is the point at which the peak thrombin height is reached. Peak thrombin is the maximum thrombin height, and endogenous thrombin potential (ETP) is the area under the thrombin generation curve.


Cited by  1 articles

Comparison of the International Normalized Ratio Between a Point-of-Care Test and a Conventional Laboratory Test: the Latter Performs Better in Assessing Warfarin-induced Changes in Coagulation Factors
Ye-Seul Kim, Jae-Woong Choi, Sang Hoon Song, Ho Young Hwang, Suk Ho Sohn, Ji Seong Kim, Yoonjin Kang, Ja-Yoon Gu, Kyung Hwan Kim, Hyun Kyung Kim
Ann Lab Med. 2023;43(4):337-344.    doi: 10.3343/alm.2023.43.4.337.


Reference

1. Kitchens CS. To bleed or not to bleed? Is that the question for the PTT? J Thromb Haemost. 2005; 3:2607–2611. PMID: 16150051.
Article
2. Dargaud Y, Trzeciak MC, Bordet JC, Ninet J, Negrier C. Use of calibrated automated thrombinography +/- thrombomodulin to recognise the prothrombotic phenotype. Thromb Haemost. 2006; 96:562–567. PMID: 17080211.
Article
3. Tripodi A, Arbini A, Chantarangkul V, Mannucci PM. Recombinant tissue factor as substitute for conventional thromboplastin in the prothrombin time test. Thromb Haemost. 1992; 67:42–45. PMID: 1615481.
Article
4. Simioni P, Castoldi E, Lunghi B, Tormene D, Rosing J, Bernardi F. An underestimated combination of opposites resulting in enhanced thrombotic tendency. Blood. 2005; 106:2363–2365. PMID: 15961511.
Article
5. Hron G, Kollars M, Binder BR, Eichinger S, Kyrle PA. Identification of patients at low risk for recurrent venous thromboembolism by measuring thrombin generation. JAMA. 2006; 296:397–402. PMID: 16868297.
Article
6. Brandts A, van HylckamaVlieg A, Rosing J, Baglin TP, Rosendaal FR. The risk of venous thrombosis associated with a high endogenous thrombin potential in the absence and presence of activated protein C. J Thromb Haemost. 2007; 5:416–418. PMID: 17116237.
Article
7. Castoldi E, Govers-Riemslag JW, Pinotti M, Bindini D, Tans G, Berrettini M, et al. Coinheritance of Factor V (FV) Leiden enhances thrombin formation and is associated with a mild bleeding phenotype in patients homozygous for the FVII 9726+5G>A (FVII Lazio) mutation. Blood. 2003; 102:4014–4020. PMID: 12881304.
Article
8. Osterud B, Rapaport SI. Activation of factor IX by the reaction product of tissue factor and factor VII: additional pathway for initiating blood coagulation. Proc Natl Acad Sci U S A. 1977; 74:5260–5264. PMID: 271951.
Article
9. Branchi A, Rovellini A, Sommariva D, Gugliandolo AG, Fasoli A. Effect of three fibrate derivatives and of two HMG-CoA reductase inhibitors on plasma fibrinogen level in patients with primary hypercholesterolemia. Thromb Haemost. 1993; 70:241–243. PMID: 8236126.
Article
10. Chan P, Tomlinsoin B, Tsai CW, Pan WH, Lee YS. Thrombophilia in patients with hypercholesterolemia. Metabolism. 1996; 45:966–969. PMID: 8769353.
Article
11. Chan P, Huang TY, Shieh SM, Lin TS, Tsai CW. Thrombophilia in patients with hypertriglyceridemia. J Thromb Thrombolysis. 1997; 4:425–429. PMID: 10639647.
12. Bowman R, Joosen AM, Welch AA, Luben RN, Khaw KT, Wareham NJ, et al. Factor VII, blood lipids and fat intake: gene-nutrient interaction and risk of coronary heart disease with the factor VII R353Q polymorphism. Eur J Clin Nutr. 2009; 63:771–777. PMID: 18398422.
Article
13. Silveira A. Postprandial triglycerides and blood coagulation. Exp Clin Endocrinol Diabetes. 2001; 109:S527–S532. PMID: 11453040.
Article
14. Undas A, Brummel-Ziedins KE, Mann KG. Statins and blood coagulation. Arterioscler Thromb Vasc Biol. 2005; 25:287–294. PMID: 15569822.
Article
15. Hemker HC, Giesen P, Al Dieri R, Regnault V, de Smedt E, Wagenvoord R, et al. Calibrated automated thrombin generation measurement in clotting plasma. Pathophysiol Haemost Thromb. 2003; 33:4–15. PMID: 12853707.
Article
16. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment panel III) final report. Circulation. 2002; 106:3143–3421. PMID: 12485966.
17. Kim SY, Kim JE, Kim HK, Kim I, Yoon SS, Park S. Influence of coagulation and anticoagulant factors on global coagulation assays in healthy adults. Am J Clin Pathol. 2013; 139:370–379. PMID: 23429374.
Article
18. Hoffman CJ, Lawson WE, Miller RH, Hultin MB. Correlation of vitamin K-dependent clotting factors with cholesterol and triglycerides in healthy young adults. Arterioscler Thromb. 1994; 14:1737–1740. PMID: 7947597.
Article
19. Duchemin J, Pan-Petesch B, Arnaud B, Blouch MT, Abgrall JF. Influence of coagulation factors and tissue factor concentration on the thrombin generation test in plasma. Thromb Haemost. 2008; 99:767–773. PMID: 18392335.
Article
20. Omarova F, Uitte De Willige S, Ariëns RA, Rosing J, Bertina RM, Castoldi E. Inhibition of thrombin-mediated factor V activation contributes to the anticoagulant activity of fibrinogen γ'. J Thromb Haemost. 2013; 11:1669–1678. PMID: 23848367.
Article
21. Mayer J, Eller T, Brauer P, Solleder EM, Schäfer RM, Keller F, et al. Effects of long-term treatment with lovastatin on the clotting system and blood platelets. Ann Hematol. 1992; 64:196–201. PMID: 1581407.
Article
Full Text Links
  • ALM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr