Circadian rhythms of fibrinogen and antithrombin III in liver cirrhosis.

Abstract

Background: Since acquired deficiencies of fibrinogen and antithrombin III are reported in liver cirrhosis and it is known that their plasma levels fluctuate during the day, the circadian rhythms of plasma fibrinogen and plasma antithrombin III were investigated in patients with compensated and decompensated cirrhosis, compared to healthy controls.

Methods: Three groups of subject were considered: (A) 10 healthy controls; (B) 10 patients with compensated liver cirrhosis; (C) 10 patients with decompensated liver cirrhosis. The fibrinogen and antithrombin III levels were determined in blood samples drawn in each studied subject during the span of a whole day and every three hours starting from midnight. The time-related data were analyzed by means of the "mean-group cosinor" method.

Results: Significant (p < 0.05) circadian rhythms were detected for the two variables in groups A and B, with peaks in the afternoon hours. No significant (p > 0.05) rhythms were found for group C. A significant (p < 0.05) difference was found between the three groups regarding the circadian rhythm of fibrinogen, and between controls and patients with compensated cirrhosis and between compensated and decompensated patients regarding the circadian rhythm of antithrombin III.

Conclusions: These data suggest that in healthy subjects the plasma levels of fibrinogen and antithrombin III present daily variations with own circadian rhythms, and that liver cirrhosis is associated with chronobiological circadian changes in the coagulation system, related to the stage of the disease. This progressive derangement could be considered as an index of evolution in the natural history of cirrhosis of the liver.