Hyperviscosity and microproteinuria in central obesity: relevance to cardiovascular risk.
OBJECTIVE
To investigate the role of blood rheology changes in the occurrence of glomerular proteinuria in obese patients with central fat distribution.


METHODS
Fifty-nine obese out-patients (31 with central and 28 with peripheral body fat distribution) and 24 healthy subjects.


METHODS
Blood and plasma viscosity (Rotational viscometer CV100 HAAKE), erythrocyte deformability (whole-blood filtration time), fibrinogen (nephelometry), urinary excretion rates of albumin, IgG, transferrin and IgA (nephelometry).


RESULTS
Higher blood viscosity (at low and high shear-rates), plasma viscosity, fibrinogen, erythrocyte aggregability and lower erythrocyte deformability were found in patients with central obesity than in patients with peripheral obesity (P < 0.01) and in healthy subjects (P < 0.001). Furthermore an increased urinary excretion rate of albumin (P < 0.001), IgG (P < 0.001), transferrin (P < 0.01) and IgA (P < 0.05) was found in patients with central obesity than in the other two groups. Blood hyperviscosity (at shear-rate 1 s-1 and 1/200 ratio) significantly correlated with the amount of urinary excretion of proteins independently of the other clinical and metabolic variables.


CONCLUSIONS
The data demonstrated haemorheologic disorders related to pathologic proteinuria in patients with central obesity. The interaction between these two components may increase the risk of widespread cardiovascular disease.
Solerte
S B
SB
Department of Internal Medicine, University of Pavia, Ospedale S. Margherita, Italy.
Fioravanti
M
M
Pezza
N
N
Locatelli
M
M
Schifino
N
N
Cerutti
N
N
Severgnini
S
S
Rondanelli
M
M
Ferrari
E
E
D000328:Adult; D000419:Albuminuria; D001809:Blood Viscosity; D001824:Body Constitution; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D004907:Erythrocyte Deformability; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007070:Immunoglobulin A / Q000652:urine; D007074:Immunoglobulin G / Q000652:urine; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011507:Proteinuria; D012212:Rheology; D012307:Risk Factors; D014168:Transferrin / Q000652:urine
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D014168:Transferrin