Mild liver abnormalities associated with elevated plasma factor VII and protein C in hypertriglyceridaemic patients

It is now well established that not only atheroma, but also thrombosis play a key role in coronary heart disease. High levels of some haemostatic parameters, which increase the risk of thrombosis, are often associated with lipid abnormalities. The mechanism by which patients with hyperlipidaemia display an increase in some haemostatic parameters remains to be established. Therefore, in this study, we measured factor VII antigen and its clotting activity as well as protein C-activity in a population of patients who had been referred to us for hyperlipidaemia.

We carefully selected a population of 130 healthy asymptomatic males. The study population consisted of patients aged 45.5 +/- 12.3 years with mean (+/- SD) levels of cholesterol and triglycerides of 2.60 +/- 0.58 g/L and 1.82 +/- 1.95 g/L, respectively.

We found higher levels of plasma factor VII activity, antigen and protein C activity in patients displaying hypertriglyceridaemia. In a univariate analysis there was a significant and positive correlation between these coagulating factors and the hepatic enzymes. In a multivariate analysis the three parameters which could significantly account for the variation of factor VII antigen were age, hepatic enzyme and triglyceride concentrations whereas only triglyceride levels were associated with factor VII activity; The parameters associated with protein C levels were the concentration of the hepatic enzymes and the levels of serum triglycerides.

We suggest that mild liver abnormalities such as steatosis may be one of the factors which can lead to an increase in factor VII and protein C levels.