Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstr. 2, Augsburg, 86156, Germany.
Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, 85764, Germany.
Lipids Health Dis. 2023 Jun 29;22(1):83. doi: 10.1186/s12944-023-01854-8.
Population-based studies investigating the association between blood coagulation markers and non-alcoholic fatty liver disease (NAFLD) are rare. Thus, we aimed to investigate the relationship between the Fatty Liver Index (FLI) as a measure of hepatic steatosis and plasma concentrations of antithrombin III, D-dimer, fibrinogen D, protein C, protein S, factor VIII, activated partial thromboplastin time (aPTT), quick value and international thromboplastin time (INR) in the general population.
After the exclusion of participants with anticoagulative treatment, 776 participants (420 women and 356 men, aged 54-74 years) of the population-based KORA Fit study with analytic data on hemostatic factors were included in the present analysis. Linear regression models were used to explore the associations between FLI and hemostatic markers, adjusted for sex, age, alcohol consumption, education, smoking status, and physical activity. In a second model, additional adjustments were made for the history of stroke, hypertension, myocardial infarction, serum non-HDL cholesterol levels, and diabetes status. In addition, analyses were stratified by diabetes status.
In the multivariable models (with or without health conditions), significantly positive associations with FLI were obtained for plasma concentrations of D-dimers, factor VIII, fibrinogen D, protein C, protein S, and quick value, while INR and antithrombin III were inversely associated. These associations were weaker in pre-diabetic subjects and largely disappeared in diabetic patients.
In this population-based study, an increased FLI is clearly related to changes in the blood coagulation system, possibly increasing the risk of thrombotic events. Due to a generally more pro-coagulative profile of hemostatic factors, such an association is not visible in diabetic subjects.
基于人群的研究调查血液凝固标志物与非酒精性脂肪性肝病（NAFLD）之间的关系很少。因此，我们旨在研究脂肪肝指数（FLI）作为肝脂肪变性的衡量标准与血浆抗凝血酶 III、D-二聚体、纤维蛋白原 D、蛋白 C、蛋白 S、VIII 因子、活化部分凝血活酶时间（aPTT）、快速值和国际标准化比值（INR）在普通人群中的关系。
排除接受抗凝治疗的参与者后，本研究纳入了人群基础 KORA Fit 研究中具有止血因子分析数据的 776 名参与者（420 名女性和 356 名男性，年龄 54-74 岁）。线性回归模型用于探索 FLI 与止血标志物之间的关系，调整了性别、年龄、饮酒、教育、吸烟状况和身体活动。在第二个模型中，进一步调整了中风、高血压、心肌梗死、血清非高密度脂蛋白胆固醇水平和糖尿病状况的历史。此外，还按糖尿病状况进行了分层分析。
在多变量模型（有或没有健康状况）中，与 FLI 呈显著正相关的有血浆 D-二聚体、VIII 因子、纤维蛋白原 D、蛋白 C、蛋白 S 和快速值，而 INR 和抗凝血酶 III 呈负相关。在糖尿病前期患者中，这些关联较弱，而在糖尿病患者中，这些关联基本消失。
在这项基于人群的研究中，FLI 的增加与血液凝固系统的变化明显相关，可能增加血栓事件的风险。由于止血因子的一般更促凝谱，这种关联在糖尿病患者中不可见。
