Final answer:
Liver dysfunction leads to bleeding disorders due to decreased synthesis of clotting factors. The liver's ability to produce factors necessary for the coagulation cascade is impaired in conditions like cirrhosis, resulting in an increased risk of bleeding. This is often represented by a prolonged international normalized ratio (INR).
Step-by-step explanation:
Liver dysfunction is associated with bleeding disorders primarily due to decreased synthesis of clotting factors. The liver is responsible for producing key coagulation factors, including fibrinogen (factor I), prothrombin (factor II), and factors V, VII, IX, X, and XI, as well as anticoagulant proteins such as protein C, protein S, and antithrombin. When the liver is damaged, as in conditions like cirrhosis or due to other causes such as hepatitis, alcohol abuse, or certain genetic disorders, its ability to produce these factors is impaired. This can lead to an increased risk of bleeding as the coagulation cascade—the sequence of events that normally leads to blood clot formation—is disrupted.
An indicator of this impaired function is a prolonged international normalized ratio (INR), which measures the speed of the coagulation pathway. An increased INR means that blood is taking longer to clot, indicating a deficiency in vitamin K-dependent clotting factors which are synthesized by the liver.
In addition, liver diseases such as hemochromatosis or cancer can further compromise the liver's ability to produce clotting factors, exacerbating the risk of bleeding. Overall, liver dysfunction leads to increased bleeding risk due to the inadequate production of clotting factors it synthesizes.