Department of Medical Analytics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
Department of Laboratory Diagnostics, Independent Public Clinical Hospital No 2, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
Thromb Res. 2019 Oct;182:79-88. doi: 10.1016/j.thromres.2019.08.015. Epub 2019 Aug 22.
In this paper we tested a group of 66 healthy volunteers in terms of the influence of circadian rhythm on selected parameters of the coagulation system and fibrinolytic system. Blood was collected at 6-hour intervals, at 8 am, 2 pm, 8 pm and 2 am. Circadian variability was observed in the coagulation system parameters as well as in the fibrinolytic system. We observed increased platelet aggregation, APTT prolongation, along with increased levels of factors (fibrinogen, PAI-1) and PAP and TAT complexes that influence coagulation and fibrinolysis systems, in the blood samples collected in the morning (8 am). We also demonstrated a circadian rhythm in the number of circulating platelets (PLT), with a peak in the afternoon (2 pm) accompanied by increased concentrations of t-PA, D-dimers and PT prolongation. Based on the obtained results it was possible to conclude that circadian rhythm had an influence on the activation of coagulation processes in the morning, with a progressive activation of fibrinolysis up to the afternoon. Our results may be helpful in determining the transient risk of cardiovascular events, including myocardial infarction and ischemic stroke, and hence, can contribute to the effective prevention of such events. Such observations may also become a starting point of departure for further studies aimed at determining the circadian effect of secretion of parameters in the hemostasis system on the other systems and parameters in the human body.
在这项研究中，我们测试了一组 66 名健康志愿者，以评估昼夜节律对凝血系统和纤维蛋白溶解系统中部分参数的影响。每隔 6 小时采集一次血样，时间分别为上午 8 点、下午 2 点、晚上 8 点和凌晨 2 点。我们观察到凝血系统和纤维蛋白溶解系统中的参数存在昼夜节律变化。我们发现，早晨（8 点）采集的血样中血小板聚集、APTT 延长，以及影响凝血和纤维蛋白溶解系统的因子（纤维蛋白原、PAI-1）和 PAP、TAT 复合物的水平升高。我们还发现循环血小板（PLT）的数量存在昼夜节律，下午（2 点）达到峰值，同时 t-PA、D-二聚体浓度升高，PT 延长。基于这些结果，我们可以得出结论，昼夜节律对早晨凝血过程的激活有影响，纤维蛋白溶解在下午逐渐增强。我们的研究结果有助于确定心血管事件（包括心肌梗死和缺血性中风）的短暂风险，从而有助于有效地预防此类事件。这些观察结果也可能成为进一步研究的起点，旨在确定止血系统中参数分泌的昼夜节律对人体其他系统和参数的影响。
