Lipids, Blood Coagulation, and Fibrinolysis

Abstract

The platelet lipids playing the chief role in clotting are phosphatidylserine and phosphatidylethanolamine. The ethanolamine phosphoglycerides contain significant amounts of plasmalogen, a phosphatide of uncertain function. Phosphatidylserine and phosphatidylethanolamine are active in most clotting systems but phosphatidylethanolamine is inactive in the throm-boplastin generation test. Much effort and energy has been expended in an attempt to show that dietary ingestion of fat significantly alters blood coagulation and fibrinolysis and promotes a "hypercoagulable" state. To date this thesis remains unproved. Other efforts to link accelerated coagulation and fibrinolysis, elevated plasma lipid levels and the occurrence of human atherosclerosis have likewise been unsuccessful. Experiments in which "thrombogenic diets" were fed to experimental animals have yielded interesting results but it is doubtful whether they throw much light on the pathogenesis of human atherosclerosis. At present there seems to be little unquestioned evidence that the dietary ingestion of fat has an effect on blood coagulation or fibrinolysis of any clinical importance. However the subject still remains open.