Risk of reduced platelet counts in patients with nonalcoholic fatty liver disease (NAFLD): a prospective cohort study

Abstract

BackgroundThe production of peripheral platelet is mainly regulated by thrombopoietin, which is a glycoprotein hormone predominantly synthesized in the liver. Previously, many studies have reported that there was an inverse correlation between the degree of chronic viral hepatitis and the peripheral platelet count. However, the effect of nonalcoholic fatty liver disease (NAFLD) on the peripheral platelet counts remains unclear.MethodsWith 1303 participants from “The prevention of MS and multi-metabolic disorders in Jiangsu province of China (PMMJS)” cohort study, we investigated the associations between NAFLD and the risk of platelet counts reduction in Chinese adults. The paired-samples T test was used to explore the platelet counts changes between baseline and follow-up. Multivariate logistic regression was used to examine the association between presence of NAFLD and the risk of platelet reduction by calculating the odds ratios (ORs) and 95% confidence interval (CI).ResultsAfter five years of follow-up, platelet counts were markedly reduced from 220.6 ± 42.22 (109/L) at baseline to 208.41 ± 40.70 (109/L) at follow-up in NAFLD group (P < 0.0001). However, platelet counts were slightly lowered from 213.2 ± 43.26(109/L) at baseline to 211.8 ± 41.65 (109/L) at follow-up in non-NAFLD people (P = 0.2349). Meanwhile, there was a significant association between NAFLD and the risks of platelet count reduction, even after adjustment for confounding variables (OR: 1.68, 95% CI: 1.06–2.67). Additionally, among the participants with BMI ≤ 23 kg/m2 and SUA ≤ 344.3 μmol/L, the NAFLD participants have an increased risk of platelet count reduction compared to the persons in non-NAFLD group.ConclusionsOur present results suggested that NAFLD individuals have an increased risk of platelet counts reduction.Electronic supplementary materialThe online version of this article (10.1186/s12944-018-0865-7) contains supplementary material, which is available to authorized users.

Pemafibrate decreases markers of hepatic inflammation in patients with non-alcoholic fatty liver disease

“…Patients with NAFLD have a higher risk of having a reduced platelet count compared with people without NAFLD [ 13 ]. Recently, the effect of platelets on hepatic regeneration and suppression of fibrosis has been reported in a murine model [ 14 ].…”

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

“…It was previously suggested, that different etiologies may be associated with different hepatic damage mechanisms relating to platelets which play a role in the induction of hepatic fibrosis[ 30 , 31 ]. A previous study in NAFLD, showed that PTC were decreased in cirrhotics over a 5 year follow up compared to healthy controls[ 14 ]. Additionally, a negative correlation between the PTC and the severity of liver fibrosis in NAFLD patients has been demonstrated; a linear decrease of the PTC was correlated with increasing histological fibrosis stage.…”

“…While the association between thrombocytopenia and cirrhosis is well-established, little is known about the association between subtle changes in platelet counts over time and the long-term risk of cirrhosis development. Few previous studies have shown that platelet counts may start to fall earlier in the course of NAFLD and HCV induced liver diseases[ 13 , 14 ]. Additionally, platelet counts have been incorporated into non-invasive tools for the diagnosis of liver fibrosis and cirrhosis.…”

Diagnostic Performance of microRNA-122 and microRNA-224 in Hepatitis C Virus-Induced Hepatocellular Carcinoma (HCC)

“…These results are expected and simply explained by the damage of the adjacent hepatocytes resulting from tumor growth and interference with their blood supply or continues hepatocyte necrosis due to active cirrhosis or chronic active hepatitis (El-Serag and Rudolph, 2007;Okonkwo et al, 2011;Domingo et al, 2013;Baghdady et al, 2014). In addition to decreased thrombopoietin, which is a glycoprotein synthesized primarily in the liver and regulates the production of peripheral platelets (Liu et al, 2018).…”