Abnormal lipid profiles are associated with markers of impaired fibrinolysis in patients with cirrhosis.
- 1Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
- 2Roger Williams Institute of Liver Studies, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Foundation for Liver Research and King's College Hospital, London, UK.
- 3Liver Intensive Therapy Unit, Institute of Liver Studies, King's College Hospital, Denmark Hill, London, UK.
Abstract
Background
Patients with liver cirrhosis exhibit abnormalities in lipid metabolism and in circulating proteins of clot breakdown. Recent studies have shown relationships between dyslipidemia and fibrinolytic abnormalities in noncirrhotic populations.Objectives
We investigated associations between lipid profiles and fibrinolytic markers in patients with cirrhosis.Methods
This observational study analyzed samples from 147 patients with stable cirrhosis, decompensated cirrhosis, acute-on-chronic liver failure, and sepsis without pre-existing chronic liver disease, and from 38 healthy controls. We studied fibrinolysis by clot lysis time (CLT), plasminogen, plasminogen activator inhibitor-1 (PAI-1), and tissue-type plasminogen activator (tPA), and lipid profiles by apolipoproteins A1 and B, common lipoproteins, triglycerides, and total cholesterol.Results
CLT was slightly enhanced in stable and decompensated cirrhosis, but prolonged in acute-on-chronic liver failure and sepsis. Plasminogen levels decreased, whereas PAI-1 and tPA increased with cirrhosis severity. All lipid parameters decreased with cirrhosis severity, besides triglyceride levels, which were preserved. In an analysis of all patients with cirrhosis combined, apolipoprotein A1 correlated inversely with CLT, levels of PAI-1 and tPA, and positively with plasminogen. Apolipoprotein B, low-density lipoprotein, and lipoprotein(a) correlated positively with plasminogen. Triglycerides correlated positively with CLT.Conclusion
Cirrhosis is characterized by decreased (apo)lipoprotein levels, preserved triglyceride levels, and a shift from enhanced to impaired fibrinolysis with increasing disease severity. Lower apolipoprotein A1 levels and higher triglyceride levels are associated with impaired fibrinolysis, which may reflect biological interactions between lipid metabolism and fibrinolysis or parallel alterations secondary to hepatic dysfunction.
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BibTeX
@article{elvers2026abnormal,
title = {{Abnormal lipid profiles are associated with markers of impaired fibrinolysis in patients with cirrhosis.}},
author = {Fynn L Elvers and Jelle Adelmeijer and Marilena Stamouli and William Bernal and Vishal C Patel and Ton Lisman},
journal = {Research and practice in thrombosis and haemostasis},
year = {2026},
month = sep,
doi = {10.1016/j.rpth.2026.106975},
url = {https://europepmc.org/article/MED/42898083},
note = {CC BY},
}
RIS
TY - JOUR
TI - Abnormal lipid profiles are associated with markers of impaired fibrinolysis in patients with cirrhosis.
AU - Fynn L Elvers
AU - Jelle Adelmeijer
AU - Marilena Stamouli
AU - William Bernal
AU - Vishal C Patel
AU - Ton Lisman
PY - 2026
DA - 2026/09/18
JO - Research and practice in thrombosis and haemostasis
DO - 10.1016/j.rpth.2026.106975
UR - https://europepmc.org/article/MED/42898083
AB - Background Patients with liver cirrhosis exhibit abnormalities in lipid metabolism and in circulating proteins of clot breakdown. Recent studies have shown relationships between dyslipidemia and fibrinolytic abnormalities in noncirrhotic populations.Objectives We investigated associations between lipid profiles and fibrinolytic markers in patients with cirrhosis.Methods This observational study analyzed samples from 147 patients with stable cirrhosis, decompensated cirrhosis, acute-on-chronic liver failure, and sepsis without pre-existing chronic liver disease, and from 38 healthy controls. We studied fibrinolysis by clot lysis time (CLT), plasminogen, plasminogen activator inhibitor-1 (PAI-1), and tissue-type plasminogen activator (tPA), and lipid profiles by apolipoproteins A1 and B, common lipoproteins, triglycerides, and total cholesterol.Results CLT was slightly enhanced in stable and decompensated cirrhosis, but prolonged in acute-on-chronic liver failure and sepsis. Plasminogen levels decreased, whereas PAI-1 and tPA increased with cirrhosis severity. All lipid parameters decreased with cirrhosis severity, besides triglyceride levels, which were preserved. In an analysis of all patients with cirrhosis combined, apolipoprotein A1 correlated inversely with CLT, levels of PAI-1 and tPA, and positively with plasminogen. Apolipoprotein B, low-density lipoprotein, and lipoprotein(a) correlated positively with plasminogen. Triglycerides correlated positively with CLT.Conclusion Cirrhosis is characterized by decreased (apo)lipoprotein levels, preserved triglyceride levels, and a shift from enhanced to impaired fibrinolysis with increasing disease severity. Lower apolipoprotein A1 levels and higher triglyceride levels are associated with impaired fibrinolysis, which may reflect biological interactions between lipid metabolism and fibrinolysis or parallel alterations secondary to hepatic dysfunction.
SN - 2475-0379
ER -