Aggregation ability of platelets in hypertensive patients with obesity and non-alcoholic fatty liver disease
Background. Activation of platelets and their aggregation are central processes in the pathophysiology of coronary heart disease. The relationship between mortality and cardiovascular morbidity varies depending on the presence of other concomitant cardiovascular risk factors. Materials and methods. Ninety one patients were examined. Their average age was (57.9 ± 9.4) years. Three groups of patients were identified: I — 36 persons with stage 2 hypertension and non-alcoholic fatty liver disease (NAFLD), II — 28 patients with NAFLD without hypertension, group III — 27 patients with stage 2 hypertension without NAFLD. Results. A significant increase of spontaneous aggregation degree was revealed in all groups: in patients with stage 2 hypertension — threefold (p < 0.05), in group with NAFLD — by 4.2 times (p < 0.001), in group with stage 2 hypertension and NAFLD — sevenfold (p < 0.01). The degree of adenosine diphosphate-induced platelet aggregation increased in all patients: with stage 2 hypertension — by 116 % (p < 0.05), NAFLD and stage 2 hypertension — by 93 % (p < 0.001), with NAFLD alone — by 71.7 % (p < 0.05). The degree of arachidonic acid-induced platelet aggregation decreased by 8.3 % (p < 0.05) in the group of NAFLD with stage 2 hypertension. Conclusions. An increase of the functional activity of platelets is observed in hypertension, the severity of which increases significantly in combination with NAFLD. Patients with NAFLD alone had also significant increase in spontaneous platelet aggregation. It allows us to consider NAFLD as one of the risk factors for thrombophilic changes in the primary link of hemostasis.
Full Text:PDF (Русский)
Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011 Feb 12;377(9765):557-67. doi: 10.1016/S0140-6736(10)62037-5.
Garvey WT, Mechanick JI, Brett EM, et al. American association of clinical endocrinologists and american college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016 Jul;22 Suppl 3:1-203. doi: 10.4158/EP161365.GL.
Mashura GJu. Optymizacija diagnostyky i likuvannja hvoryh na nealkogol'nu zhyrovu hvorobu pechinky u pojednanni z gipertonichnoju hvoroboju z urahuvannjam smakovoi' chutlyvosti do hlorydu natriju. Diss. kand. med. nauk [Optimization of the diagnosis and treatment of patients with non-alcoholic fatty liver disease in combination with hypertension considering taste sensitivity to sodium chloride. PhD diss.]. Uzhgorod; 2017. 22 p. (in Ukrainian).
Raziel A, Sakran N, Szold A, Goitein D. Current solutions for obesity-related liver disorders: non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Isr Med Assoc J. 2015 Apr;17(4):234-8.
Ivashkin VT, Drapkina OM, Mayev IV, et al. Prevalence of non-alcoholic fatty liver disease in out-patients of the Russian Federation: DIREG 2 study results. Rossiiskii zhurnal gastroenterologii, gepatologii, koloproktologii. 2015;25(6):31-41. (in Russian).
Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the american association for the study of liver diseases. Hepatology. 2018 Jan;67(1):328-357. doi: 10.1002/hep.29367.
Syvolap VV, Zhemanyuk SP. Indicators of ADP-induced platelet aggregation in patients with hypertension complicated by hemispheric ischemic stroke. Zaporozhye Medical Journal. 2017;19(104):534-539. doi: 10.14739/2310-1210.2017.5.110080. (in Ukrainian).
European Association for the Study of the Liver (EASL)1; European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016 Jun;64(6):1388-402. doi: 10.1016/j.jhep.2015.11.004.
Zaccardi F, Rocca B, Pitocco D, Tanese L, Rizzi A, Ghirlanda G. Platelet mean volume, distribution width, and count in type 2 diabetes, impaired fasting glucose, and metabolic syndrome: a meta-analysis. Diabetes Metab Res Rev. 2015 May;31(4):402-10. doi: 10.1002/dmrr.2625.
Garjani A, Safaeiyan A, Khoshbaten M. Association between platelet count as a noninvasive marker and ultrasonographic grading in patients with nonalcoholic fatty liver disease. Hepat Mon. 2015 Jan 18;15(1):e24449. doi: 10.5812/hepatmon.24449.
Ruiz-Argüelles GJ, Velazquez-Sanchez-De-Cima S, Zamora-Ortiz G, Hernandez-Reyes J, Ruiz-Delgado GJ. Nonalcoholic fatty liver disease may cause thrombocytopenia. Acta Haematol. 2014;132(2):159-62. doi: 10.1159/000357934.
Fang KC, Cheng YL, Su CW, et al. Higher platelet counts are associated with metabolic syndrome independent of fatty liver diagnosis. J Chin Med Assoc. 2017 Mar;80(3):125-132. doi: 10.1016/j.jcma.2016.07.003.
Medvedev IN, Skoryatina IA. Aggregation properties of blood cells and vascular control over them in patients with arterial hypertension and dyslipidemia. Russian Journal of Cardiology. 2015;20(4):18-22. doi: 10.15829/1560-4071-2015-4-18-22. (in Russian).
Samoilova SO. State of the coagulation link and platelet hemostasis system in patients with hypertension in combination with COPD: literature review and results of own research. Visnyk mors'koi' medycyny. 2016;(2):105-116. (in Ukrainian).
Copyright (c) 2019 GASTROENTEROLOGY
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018