title: Visceral fat as a determinant of fibrinolysis and hemostasis.
abstract: An increased amount of deep abdominal visceral fat has generally been accepted as an important cardiovascular risk factor, and disturbances in hemostasis and fibrinolysis have been suggested to play a role. Fibrinogen and von Willebrand factor, representatives of the hemostatic system, and plasminogen activator inhibitor 1 (PAI-1), as the most important inhibitor of the fibrinolytic system, have been associated with visceral obesity, with the most convincing evidence found for the involvement of PAI-1. The association with fibrinogen and von Willebrand factor has been suggested to be merely a reflection of the association with inflammation and endothelial dysfunction. The fact that PAI-1 is secreted by adipose tissue has attracted much attention. The increase of PAI-1 in visceral obesity could be because visceral adipose tissue produces more PAI-1 compared with subcutaneous abdominal adipose tissue. The contribution of other cell types such as hepatocytes or endothelial cells is probably more important, with stimulation of PAI-1 production by different components of the metabolic syndrome. PAI-1 secretion by adipose tissue has been suggested to have a more local effect, playing a role in tissue remodeling during the development of obesity.
authors.affiliation: Department of Diabetology, Metabolism and Clinical Nutrition, Faculty of Medicine, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: Mertens
authors.forename: Luc F
authors.initials: LF
authors.lastname: Van Gaal
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D016207:Cytokines / Q000378:metabolism; D005342:Fibrinolysis / Q000502:physiology*; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology*; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014781:Viscera / Q000378:metabolism
chemical_list: D015415:Biomarkers; D016207:Cytokines; D017395:Plasminogen Activator Inhibitor 1