title: Elevation of plasma von Willebrand factor and tumor necrosis factor-a in obese subjects and their reduction by the low molecular weight heparin tinzaparin.
abstract: OBJECTIVE
  Increased plasma-soluble von Willebrand factor (vWF) level, a marker of vascular endothelial cell dysfunction, is a predictor of atherosclerotic cardiovascular disease. We compared associations between vWF level and markers of inflammation as well as the effects of LMWH in obese as compared to healthy human subjects.
  
  
  METHODS
  Plasma samples were obtained from healthy volunteers (n=32) and obese subjects (n=12) before and after administration of a single subcutaneous dose of tinzaparin, given at 75 IU/kg once a day, a deep vein thrombosis prophylaxis dose. Plasma samples were analyzed for vWF and tumor necrosis factor-alfa (TNF-alfa) using specific and sensitive ELISA.
  
  
  RESULTS
  Obese subjects showed relatively higher plasma levels of TNF-alfa compared with normal-weight subjects. Regression analysis showed that plasma vWF levels to be directly associated with the presence of higher plasma levels of TNF-alfa in these obese subjects. Tinzaparin significantly reduced elevated plasma levels of both vWF and TNF-a levels (P<0.01).
  
  
  CONCLUSIONS
  Plasma values of vWF and TNF-alfa are higher in obese than in normal-weight individuals. Treatment with tinzaparin lowers plasma levels of TNF-alfa in both obese and normal-weight subjects. The levels of vWF were higher in obese subjects than in normal-weight ones, which might be due to the higher levels of circulating TNF-alfa. Tinzaparin reduced vWF levels in these obese subjects.
authors.affiliation: Albany College of Pharmacy, Albany, NY 12208, USA. mousas@acp.edu
authors.forename: S A
authors.initials: SA
authors.lastname: Mousa
mesh_terms: D005343:Fibrinolytic Agents / Q000494:pharmacology*; D006495:Heparin, Low-Molecular-Weight / Q000494:pharmacology*; D006801:Humans; D009765:Obesity / Q000097:blood*; D000078222:Tinzaparin; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D014409:Tumor Necrosis Factor-alpha; D014841:von Willebrand Factor; D000078222:Tinzaparin