Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2025
Procoagulant imbalance is associated with hepatic and vascular complications in patients with MASLD and diabetes. Key role of factor VIII.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lombardi Rosa, Forlano Roberta, Maffi Gabriele, Cespiati Annalisa, Cinque Felice, Bignamini Daniela, Dongiovanni Paola, Francione Paolo, Sigon Giordano, Huang Jian, Manousou Pinelopi, Peyvandi Flora, Tripodi Armando, Fracanzani Anna Ludovica
Аннотация
BACKGROUND: Metabolic-dysfunction associated steatotic liver disease (MASLD) promotes fibrosis and vascular complications, especially if associated with type 2 diabetes.
AIM: To evaluate the association between procoagulant imbalance, hepatic and vascular damage.
METHODS: 185 diabetic MASLD patients (62±11ys, 59% males) underwent assessment of of FibroScan® (LSM≥8 kPa), macro- and micro-vascular complications. In 96 patient PNPLA3 genotyping, coagulation factors (i.e., factor (F)VIII, protein C (PC), antithrombin and thrombin generation assay were also assessed.
RESULTS: The endogenous-thrombin-potential [ETP (with/without thrombomodulin), called ETP-TM ratio)] and the FVIII/PC ratio increased from tertile 1 to 3 (from 0.65±0.15 to 0.92±0.41, p<0.001), as well as FVIII/PC (from 1.23±0.41 to 1.57±0.77, p=0.003) and were independently associated with increasing LSM values (b-coefficient, 6.11; CI95% 3.59-8.64; b-coefficient, 4.80; CI95% 2.28-7.32). Antithrombin and PC correlated to LSM≥ 8kpa (OR 0.92, CI95% 0.88-0.97; OR 0.97, CI95% 0.94-0.99). When added to the model, PNPLA3 modified some of these associations, but remained independently associated with peak-thrombin ratio (b-coefficient 0.063; CI95% 0.001-0.126) and antithrombin (b-coefficient -6.14; CI95% -11.82 -0.46). FVIII and fibrinogen were independently associated with micro-vascular complications.
CONCLUSION: MASLD diabetic patients display a procoagulant profile, which is independently associated with the severity of hepatic fibrosis and micro-vascular complications. PNPLA3 determine a possible procoagulant profile associated with fibrosis, but further studies are warranted to elucidate this mechanism.
AIM: To evaluate the association between procoagulant imbalance, hepatic and vascular damage.
METHODS: 185 diabetic MASLD patients (62±11ys, 59% males) underwent assessment of of FibroScan® (LSM≥8 kPa), macro- and micro-vascular complications. In 96 patient PNPLA3 genotyping, coagulation factors (i.e., factor (F)VIII, protein C (PC), antithrombin and thrombin generation assay were also assessed.
RESULTS: The endogenous-thrombin-potential [ETP (with/without thrombomodulin), called ETP-TM ratio)] and the FVIII/PC ratio increased from tertile 1 to 3 (from 0.65±0.15 to 0.92±0.41, p<0.001), as well as FVIII/PC (from 1.23±0.41 to 1.57±0.77, p=0.003) and were independently associated with increasing LSM values (b-coefficient, 6.11; CI95% 3.59-8.64; b-coefficient, 4.80; CI95% 2.28-7.32). Antithrombin and PC correlated to LSM≥ 8kpa (OR 0.92, CI95% 0.88-0.97; OR 0.97, CI95% 0.94-0.99). When added to the model, PNPLA3 modified some of these associations, but remained independently associated with peak-thrombin ratio (b-coefficient 0.063; CI95% 0.001-0.126) and antithrombin (b-coefficient -6.14; CI95% -11.82 -0.46). FVIII and fibrinogen were independently associated with micro-vascular complications.
CONCLUSION: MASLD diabetic patients display a procoagulant profile, which is independently associated with the severity of hepatic fibrosis and micro-vascular complications. PNPLA3 determine a possible procoagulant profile associated with fibrosis, but further studies are warranted to elucidate this mechanism.