Imbalance of pro- vs. anti-coagulation factors in Chinese patients with Budd-Chiari syndrome and non-cirrhotic portal vein thrombosis

PLoS One. 2015 Mar 30;10(3):e0119909. doi: 10.1371/journal.pone.0119909. eCollection 2015.

Abstract

Background and aim: The coagulation abnormalities in non-cirrhotic Budd-Chiari syndrome (NC-BCS) and non-cirrhotic portal vein thrombosis (NC-PVT) are unclear. We conducted this case-control study to investigate the coagulation profile of NC-BCS and NC-PVT in Chinese patients.

Methods: We measured the levels of factors II, V, VII, VIII, IX, X, XI, XII, protein C (PC), protein S (PS) and antithrombin (AT) in blood samples from 37 NC-BCS patients, 74 NC-PVT patients, and 100 healthy controls. The levels and ratios of pro- and anti-coagulation factors were compared between patients with NC-BCS and healthy controls, between different types of NC-BCS and between NC-PVT and healthy controls.

Results: In patients with NC-BCS, factor VIII (P<0.001) was significantly elevated; factor V (P<0.001), VII (P<0.001), IX (P = 0.003), X (P<0.001), XI (P<0.001), XII (P<0.001), PC (P<0.001) and AT (P<0.001) were significantly decreased; and no difference was observed for factor II (P = 0.088) and PS (P = 0.199) compared with healthy controls. Factor VIII-to-PC (P = 0.008), factor VIII-to-PS (P = 0.037) and factor VIII-to-AT (P = 0.001) were significantly increased; other ratios were significantly reduced or did not show any difference. No differences were observed between different types of NC-BCS for individual pro- and anti-coagulation factors or the ratios between them. Among patients with NC-PVT, factor VIII (P<0.001) was significantly elevated and other factors were significantly decreased. Factor II-to-PC (P<0.001), factor VIII-to-PC (P<0.001), factor IX-to-PC (P<0.001), factor VIII-to-PS (P<0.001), factor II-to-AT (P<0.001), factor VIII-to-AT (P<0.001) and factor IX-to-AT (P<0.001) were significantly increased; all other ratios for NC-PVT were significantly reduced or did not show any significant difference.

Conclusions: NC-BCS and NC-PVT are associated with elevated levels of factor VIII and the decreased levels of PC and AT were probably the most significant features of coagulation imbalance. Additionally, NC-PVT was associated with decreased levels of PS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antithrombins / blood
  • Asian People
  • Blood Coagulation Factors / metabolism*
  • Budd-Chiari Syndrome / blood*
  • Case-Control Studies
  • China
  • Factor VIII / metabolism
  • Female
  • Humans
  • Male
  • Middle Aged
  • Portal Vein*
  • Protein C / metabolism
  • Protein S / metabolism
  • Venous Thrombosis / blood*
  • Young Adult

Substances

  • Antithrombins
  • Blood Coagulation Factors
  • Protein C
  • Protein S
  • Factor VIII

Grants and funding

This work was supported by grant 81172145 from the National Natural Science Foundation of China (http://www.nsfc.gov.cn/) and this study was also funded by a translational research project (XJZT11ZO5) of the Xijing Hospital, Fourth Military Medical University, Xi’an, China. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.