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Bile acids and coagulation factors: paradoxical association in children with chronic liver disease

Maria Magnusson1, Björn Fischler, Jan Svensson

  • 1CLINTEC, Division of Pediatrics, Karolinska Institutet, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. maria.magnusson@ki.se

European Journal of Gastroenterology & Hepatology
|October 19, 2012
PubMed

Insights

In children with chronic liver disease, high bile acid levels correlate with certain coagulation factors. This finding questions the reliability of coagulation factors as prognostic markers when bile acids are markedly elevated.

Area of Science:

  • Pediatric Hepatology
  • Hematology
  • Biochemistry

Background:

  • Bile acids play a role in liver function and metabolism.
  • Coagulation factors are crucial for hemostasis.
  • The relationship between bile acids and coagulation in pediatric chronic liver disease is not well understood.

Purpose of the Study:

  • To investigate the association between serum bile acid levels and coagulation factors in children with chronic liver disease.
  • To determine if bile acid levels influence the predictive value of coagulation parameters.

Main Methods:

  • Cross-sectional observational study of 45 pediatric patients with chronic liver disease.
  • Analysis of coagulation factors, prothrombin time, albumin, and total fasting serum bile acids.
  • Calculation of international normalized ratio (INR) and pediatric end-stage liver disease (PELD) score.

Main Results:

  • A significant positive correlation was observed between elevated bile acids (>200 μmol/l) and Factor V, Factor VII, and prothrombin time.
  • Elevated bile acids showed a significant negative correlation with INR.
  • Patients with markedly elevated bile acids had a worse clinical outcome.

Conclusions:

  • A positive correlation exists between bile acids and coagulation factors in pediatric chronic liver disease patients with high bile acid levels.
  • Coagulation factors may be unreliable prognostic markers in the presence of significantly elevated bile acids.
Abstract

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