Hemorheological Alteration in Patients Clinically Diagnosed with Chronic Liver Diseases

Abstract

Since liver function is changed by chronic liver diseases, chronic liver disease can lead to different hemorheological alterations during the course of the progression. This study aims to compare alterations in whole blood viscosity in patients with chronic liver disease, focusing on the gender effect. Chronic liver diseases were classified into three categories by patient's history, serologic markers, and radiologic findings: nonalcoholic fatty liver disease (NAFLD) (n = 63), chronic viral hepatitis B and C (n = 50), and liver cirrhosis (LC) (n = 35). Whole blood viscosity was measured by automated scanning capillary tube viscometer, while liver stiffness was measured by transient elastography using FibroScan®. Both systolic and diastolic whole blood viscosities were significantly lower in patients with LC than NAFLD and chronic viral hepatitis (P < 0.001) in male patients, but not in female patients. In correlation analysis, there were inverse relationships between both systolic and diastolic whole blood viscosity and liver stiffness (systolic: r = -0.25, diastolic: r = -0.22). Whole blood viscosity was significantly lower in male patients with LC than NAFLD or chronic viral hepatitis. Our data suggest that whole blood viscosity test can become a useful tool for classifying chronic liver disease and determining the prognosis for different types of chronic liver diseases.

Keywords: Chronic Liver Disease; Hemorheology; Whole Blood Viscosity.

Fig. 1

Classification of patients with chronic liver disease who underwent whole blood viscosity test according to clinical and radiological diagnosis. WBV = whole blood viscosity, NAFLD = nonalcoholic fatty liver disease.

Fig. 2

Total (A), male (B) and female (C) systolic and diastolic whole blood viscosity according to diagnosis. The boxplots show systolic and diastolic whole blood viscosity are significantly lower in patients with liver cirrhosis than other patients. Median (range) values of total, male and female whole blood viscosity according to diagnosis; systolic and diastolic whole blood viscosity (D). cP = centipoises, NAFLD = nonalcoholic fatty liver disease, CVH = chronic viral hepatitis, LC = liver cirrhosis, WBV = whole blood viscosity. ^*P < 0.05, ^†P < 0.001.

Fig. 3

Correlation between transient elastography and whole blood viscosity; systolic (A) and diastolic (B) whole blood viscosity. The linear regression analyses show that there are weak inverse correlation between liver stiffness and whole blood viscosity, both systolic and diastolic. WBV = whole blood viscosity, cP = centipoises, kPa = kilopascals.