Weight loss reduces tissue factor in morbidly obese patients.
OBJECTIVE
To investigate the tissue factor (TF) pathway in clinical obesity and associated metabolic syndrome.


METHODS
Thirty-seven morbidly obese patients (4 men; BMI, 48 +/- 7 kg/m(2); range, 42 to 53 kg/m(2)), undergoing elective gastroplasty for the induction of weight loss, were examined for hemostatic, metabolic, and inflammatory parameters at baseline and 14 +/- 5 months postoperatively.


RESULTS
Weight loss significantly reduced circulating plasma TF (314 +/- 181 vs. 235 +/- 113 pg/mL, p = 0.04), coagulation factor VII (130 +/- 22% vs. 113 +/- 19%, p = 0.023), and prothrombin fragment F1.2 (2.4 +/- 3.4 vs. 1.14 +/- 1.1 nM, p = 0.04) and normalized glucose metabolism in 50% of obese patients preoperatively classified as diabetic or of impaired glucose tolerance. The postoperative decrease in plasma TF correlated with the decrease of F1.2 (r = 0.56; p = 0.005), a marker of in vivo thrombin formation. In subgroup analysis stratified by preoperative glucose tolerance, baseline circulating TF (402.6 +/- 141.6 vs. 176.2 +/- 58.2, p < 0.001) and TF decrease after gastroplasty (DeltaTF: 164.7 +/- 51.4 vs. -81 +/- 31 pg/mL, p = 0.02) were significantly higher in obese patients with impaired glucose tolerance than in patients with normal glucose tolerance.


CONCLUSIONS
Procoagulant TF is significantly reduced with weight loss and may contribute to a reduction in cardiovascular risk associated with obesity.
Kopp
Christoph W
CW
2nd Department of Medicine, Angiology Division, University of Vienna, General Hospital (AKH), Waehringer Guertel 18/20, A-1090 Vienna, Austria. christoph.kopp@univie.ac.at
Kopp
Hans-Peter
HP
Steiner
Sabine
S
Kriwanek
Stephan
S
Krzyzanowska
Katarzyna
K
Bartok
Andrea
A
Roka
Rudolf
R
Minar
Erich
E
Schernthaner
Guntram
G
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005167:Factor VII / Q000378:metabolism; D005260:Female; D015391:Gastroplasty; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D008074:Lipoproteins / Q000097:blood / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000378:metabolism* / Q000601:surgery; D011446:Prospective Studies; D011517:Prothrombin Time; D018709:Statistics, Nonparametric; D013925:Thromboplastin / Q000378:metabolism*; D016212:Transforming Growth Factor beta / Q000097:blood; D015431:Weight Loss / Q000502:physiology*
D001786:Blood Glucose; D002097:C-Reactive Protein; D005167:Factor VII; D006442:Glycated Hemoglobin; D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; D008074:Lipoproteins; D013925:Thromboplastin; D016212:Transforming Growth Factor beta; C051928:lipoprotein-associated coagulation inhibitor