al tryyn pryerymyentsye.

: 98, 1965.

apyeratsyyakh padVyestsi Akad Navuk FIBRINOLYTIC ACTIVITY AND ITS VARIATIONS -IN NORMAL

HEALTHY SUBJECTS*

ByS. KAUR AND K.S. SHARMA

Department of Physiology, M.G.M. Medical College, Indore

Morgagni (8) was the first to observe that the blood tends to remain in the fluid state incasesof sudden death cadaver. Ever since, the phenomenon has aroused the curiosity of many,notableworkers. With the p.assage of time from the flat field of speculation' of the 18thCentury, we have today ascended to a more vantage point - a mountain of hard facts. Thiscertainly has enlarged the horizon giving revelation of the processes involved in fibrinolysis.Thepicture that has emerged is an extremely complex but none the less fascinating one.

Going through the literature, it is found that there is a lack of adequate studies infibrinolytic activity in healthy Indians. Hence the necessity for taking up such studies is.apparent in order to establish tbe norms for fibrinolytic activity in healthy Indians. This willalsohelp in serving as a more accurate index for the allied studies that are undertaken in'Indians of variations of fibrinolytic activity in diseased conditions.

. W. Virtue. Surgery byia. J. Am. Med. Ass .. 153:

lcium and magnesium estimations .

MATERIALS AND METHODS

The subjects ¥Or this study were selected from amongst the medical students and doctorsbetweenthe age range 16-28 years. Each case was subjected to a thorough clinical examina-tion to exclude the possibility of any disease or deficiency. A complete history wastaken and the blood was collected under strict basal condition. Fibrinolytic activity wasdetermined by utilizing the method as outlined by Fearnley et al. (I).

Observations

A higher value for the fibrinolytic time was observed ID the females than the males,moderate than the thin built, smokers than the non-smokers and alcoholics than the non-alcoholics. Though the fibrinolytic time was higher after 12 hours refrigeration at aoe, thechangewas not statistically significant. The fibrinolytic activity did not have any relationshipto the dietetic habits as it was more or less the same in the vegetarians and non-vegetarians.Similarwere the observations for the dietary fats. The different types of fats when consumedin the usual quantity as in the normal diet, did not have any effect on the fibrinolyticactivity.

D1SCUSSIO]\;

The values observed for the fibrinolytic activity for the males, females and entire serieswerewithin normal limits. These values are in accord with the values of the previous workers.A comparison of the norrr:al values obtained for Indians in some of the recent works and thatof the present series could be effected by a study 01 Table n.

-Received 25-2-1970.

138 Kaur and Sharma

TARLE I

Showing the relation of sex, body built, smoking, alcohol drinking, dietetic habits, dietary fatnnd storage on fibrinolytic activity

Factor No. of Cases

Sex:(a) Males 135 288± 99

(b) Females(110-565)

71 343 ==171

Entire Series(125-930)

(c) 206 307±127(110-930)

Body Built:(a) Moderate 172 314±127(b) Thin 34 278± 93

Smoking:(a) Smokers 14 371 ± 92(b) Non-smokers 121 278± 97

Alcohol drinking:(a) Alcoholics 11 301 ± 91(b) Non-alcoholics 124 286± 99

Dietetic habits:(a) Vegetarian 102 308±132(b) Non-vegetarian 104 305±113

Dietary fat:(a) Dalda 24 274± 96(b) Ground nut oil 152 308±123(c) Pure ghee 30 326±147

Storage:After 1 hour refrigeration at O°C(a) 10 296± 81

(b) After 12 hours refrigeration at O°C 10 354± 72

TABLE IINormal fibrinolysis time encountered b, different workers and in the present series

Workers No. of Cases Age in yrs.

Mathur et al. (7) (1964)(a) Males 203 1-70 yrs. 5.42 hrs. ==1.92

(5.05-5.82 hn](b) Females 118 1-70 yrs. 5.29 hrs. ==2.34

(4.95-5.75 hrs.)(c) Entire Series 321 1-70 yrs. 5.39 hrs. ==2.3

(2.0-12.5 hrs.)

Sikka et al. (9) (1967)(a) Males 38 30-70 yrs. 5.90 hrs.

(4.10-7.66 hrs.)(b) Females 24 30-70 yrs. 6.33 hrs.

(4.10-11.50hr1(c) Entire Series 62 30-70 yrs. 6.05 hrs.

(4.93-11.50 hn

Present Series(a) Males 135 16-28 yrs. 288 mts. ==99

(110-565 mts.)(b) Females 71 16-28 yrs. 343 mts. ==171

(125-930 mts.)(c) Entire series 206 16-28 yrs. 307 mts.±127

(110-930 mts.)

,dietetic habits, dietary fat

288= 99(110-565)343=171

(125-930)307=127

(110-930)

314=127278= 93

371= 92278= 97

301= 91286= 99

308=132305=113

274= 96308=123326=147

296= 81354= 72

d in the present series

Fibrinolysis t;;;;;-

5.42 hrs. = 1.92(5.05-5.82 hrs.)5.29 hrs. =2.34

(4.95-5.75 hrs.)5.39 hrs. =2.3

(2.0-12.5 hrs.)

o yrs. 5.90 hrs.(4.10-7.66 hrs.)6.33 hrs.

(4.10-11.50 hrs.)6.05 hrs.

(4.93-11.50 hrs.)

o yrs.

o yrs.

yrs. 288 mts.=99. (110-565 mts.)

343 mts. =171(125-930 mts.)307 mts. = 127

(110-930 mts.)t-----

yrs.

yrs.

Fibrinolytic Activity in Healthy Subjects J 39

Hume (5). Mathur et al. (7), Laha et al. (6) and Sikka et al. (9) had shown that there wasno demonstrable difference of fibrinolytic activity in the two sexes. In the present series thefemalesshowed somewhat higher fibrinolysis time as compared to males. It is perhaps due tothe majority of the females at the time of study being in the secretory phase of the menstrualcycle. William et al. (11) observed proactivator to be present throughout endometrial stroma atallstages of the menstrual cycle. They suggested that possibly changes in hormone levels eff ecttheconversion of proactivator to activator. The absence of activator in Secretory phasesuggeststhat progesterone may inhibit the conversion of proactivator. Possibly a drop in

gesterone and oestrogen levels result in the conversion of proactivator to activator.

In the present series as there was no obese subject, the fibrinolysis time was comparedbetweenmoderate and thin built. It was found that the change is not statistically significantt < 2). There is no significant difference in the mean values of fibrinolytic activity in vege-tariansand non-vegetarians. Although the number of smokers as compared to non-smokerswasvery much less for drawing any conclusion, however it is worth remarking that Soganiet al. (10) had also reported similar tendency towards diminished fibrinolytic activity with anyformof tobacco usage. Alcoholic showed a little higher value in the present series. As theseobservationsare based on 11 alcoholics only, to draw any conclusion would be untenable.However,in this context, it may be pointed out that Fearnley et al. (2) had observed consider-ablereduction in fibrinolytic activity after a pint of beer.

The consumption of different types of fats viz. pure ghee, dalda or ground-nut-oil inquantitiesas present in the usual normal diet were not attended with any marked significantdifferencesin the fibrinolytic time (t < 2). An inhibition of fibrinolytic activity was observedbyFuruta (3) during lipaemia induced after experimental forced feeding. The inhibition waslessmarked when lipaemia was due to an unsaturated fat than saturated (Greig and Runde (4),andFuruta (3).

The observations of the present series cannot be compared with the findings of theaboveworkers as the experimental conditions were totally different from the present study.However,it seems that fats when consumed in normal amounts do not much effect the processoffibrinolysis.

Storage of the blood samples for 12 hrs. at ooe was not attended with statisticallysignificant change in the fibrinolytic activity, the 't' value being < 2. The present observationsarein confirmity with the work of Mathur et al. (7).

SUMMARY

I. Fibrinolytic activity was determined in 206 normal subjects, which included135 males and 71 females. Females showed higher values as comparedto males.

2. There was no significant difference between vegetarians and non-vegetarians andmoderate built as compared to tbin built.

3. Smokers and alcoholics' showed more fibrinolysis time as compared tosmokers and non-alcoholics.

5. No significant difference in the fibrinolytic time was observed with the constion of different types of fats in the usual normal diet.

,5. ,No significant change in the fibrinolysis time was observed after 12 hrs.at ooe.

140 Kaur and Sharma

REFERENCES

1. Fearn1ey, G.R., G.V. Balmforth and E. Fearnley. Evidence of a diufibrinolytic rhythm, with a simple method of measuring natural fibrinoljClinical Science, '16 : 645, 1957:

2. Fearnley, G.R., J. Ferguson, R. Chakrabarti and C.T. Vincet. Effecton fibrinolytic activity. Lancet, 1 : 185, 1960.

3. Furuta, S. Cited by M. Howel!. Brit. Med. Bull., 20 : 3,200, 1964.

4. Greig, H.B.W. and LA. Runde. Studies on the inhibition of fibrinolysis by Lip'Lancet, 2 : 461, 1957.

5. Hume, R. The relationship to age and cerebrovascular accidents of' fibrinfibrinolytic activity. J. CUn. Path., 14 : 167,1961.

6. Laha, P.N. 'and J.P. Wali. Blood fibrinolytic activity in pulmonary tuberculThe Journal of the Association of Physicians of India, 15 : 4, 155, 1967.

7. Mathur, K.S., S.c. Gupta, D.K. Gupta and P.K. Waha!. Spontaneous fibrinchand the changes produced by (i) Adrenaline (ii) Fatty meals (iii) StorageIDiurnal rhythm. Ind. J. Med. Research., 52 : 38, 1964.

8. Morgagni, J.B. Cited by S.J. Pate!. Journal of Ind. Med. Association.,147, 1966.

9. Sikka, K.K., Kedar Nath, K.C. Samuel, S.D. Gahlaut, M.C. ShrivastavaA. Gaffar. Plasma fibrinolytic activity in Diabetes Mellitus. The Journal ofAssociation of Physicians of India, 15 : 6, 279, 1967.

10. Sogani, R.K. and K.C. Joshi, Effect of Cigarette and Bidi smoking and tobachewing on blood coagulation and fibrinolytic activity. Ind. Heart Journal,I238, 1965.

11. William, H., M.D. Luginbuhl, C. Ronald and M.D. Picoff. The localisation acharacteristics of endometrial fibrinolys-is. Am. J. Obstet. and Gynaec ..462, 1966.