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Bile acids and coagulation factors: paradoxical association in children with chronic liver disease.
MedLine Citation:
PMID:  23075699     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To examine whether there is an association between bile acids and coagulation factors in children with chronic liver disease. METHODS: Forty-five patients (age 2.8 months-18.8 years) were included in this cross-sectional observational study carried out at a single tertiary referral center. Coagulation factors, prothrombin time, albumin, and total fasting serum bile acids were analyzed. The international normalized ratio (INR) and the pediatric end-stage liver disease score were calculated. RESULTS: The 12 patients with bile acids more than 200 μmol/l showed a significant positive correlation between bile acids and factor V (FV), FVII, and prothrombin time (rs=0.80, 0.72, 0.60, P<0.05) and a significant negative correlation between bile acids and INR (rs=-0.58, P<0.05). Conversely, in the group with bile acids less than 200 μmol/l, there was a significant negative correlation between bile acids and FVII and FIX (rs=-0.41 and -0.41, P<0.05) and a positive, albeit nonsignificant, correlation between bile acids and INR. No in-vitro analytical interference between bile acids and coagulation factors was found. Patients with bile acids more than 200 μmol/l had a significantly worse outcome than patients with lower levels of bile acids. CONCLUSION: A positive correlation was found between bile acids and coagulation factors in patients with bile acids more than 200 μmol/l. Coagulation factors may be questionable as prognostic markers in patients with markedly elevated bile acids.
Authors:
Maria Magnusson; Björn Fischler; Jan Svensson; Pia Petrini; Sam Schulman; Antal Németh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-16
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  -     ISSN:  1473-5687     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aCLINTEC bDepartment of Woman and Child Health, Karolinska Institutet, Division of Pediatrics, Astrid Lindgren Children's Hospital, Karolinska University Hospital cDepartment of Clinical Sciences, Karolinska Institutet, Division of Clinical Chemistry, Danderyd Hospital, Stockholm, Sweden dDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
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