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Hyperhomocysteinemia and hypercoagulability in primary biliary cirrhosis

Maria Rosa Biagini1, Alessandro Tozzi, Rossella Marcucci

  • 1Gastroenterology Unit, Department of Clinical Pathophysiology, University of Florence, Viale Morgagni 85 50134, Firenze, Italy.

World Journal of Gastroenterology
|March 30, 2006
PubMed

Insights

Primary biliary cholangitis (PBC) patients exhibit hypercoagulability linked to elevated homocysteine (HCY) and tissue factor (TF). This suggests a role for these factors in blood clotting activation in PBC.

Area of Science:

  • Hematology
  • Biochemistry
  • Genetics

Background:

  • Primary biliary cholangitis (PBC) is a chronic liver disease with potential implications for hemostasis.
  • Understanding hypercoagulability in PBC is crucial for managing thrombotic risks.

Purpose of the Study:

  • To investigate hypercoagulability in PBC patients.
  • To assess the relationship between hypercoagulability, homocysteine (HCY), and hemostatic factors.

Main Methods:

  • Compared 51 PBC patients with 102 healthy controls using Sonoclot analysis and PFA-100.
  • Measured plasma levels of HCY, tissue factor (TF), thrombin-antithrombin complexes (TAT), D-dimer, thrombomodulin, folic acid, and vitamins B6/B12.
  • Analyzed C677T 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism.

Main Results:

  • PBC patients showed significantly higher Sonoclot RATE values (P<0.001), indicating hypercoagulability.
  • Elevated fasting and post-methionine loading HCY, TF, and TAT levels were observed in PBC patients (P<0.001).
  • Vitamin deficiencies (88.2%) and a higher prevalence of the TT677 MTHFR genotype (31.4%) were found in PBC patients.

Conclusions:

  • Hyperhomocysteinemia (hyper-HCY) in PBC is associated with hypovitaminosis and genetic factors.
  • Increased TF and HCY levels, along with signs of endothelial activation, contribute to hypercoagulability in PBC.
  • These factors play a significant role in blood clotting activation in PBC.
Abstract

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