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

• Kim JA
• Kim JE
• Song SH
• Kim HK

• KMID: 2363142
• DOI: http://doi.org/10.3343/alm.2015.35.1.15

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.

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