Hemostasis and fibrinolysis in non-diabetic overweight and obese men and women. Is there still a role for leptin?
OBJECTIVE
Leptin has been associated with disturbances in hemostasis and fibrinolysis, with inconsistent results on the influence of fat mass. However, the influence of the amount of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) has not yet been studied. In this study, we investigated the relationship between leptin and fibrinogen, von Willebrand factor antigen (vWF:Ag), and plasminogen-activator inhibitor-1 (PAI-1) activity and determined the influence of associated metabolic variables and VAT versus SAT.


METHODS
Fibrinogen, vWF:Ag, PAI-1,VAT and SAT (CT-scan), and insulin resistance (homeostasis model assessment; HOMA-IR) were measured in 199 women and 81 men with overweight or obesity visiting the weight management clinic of a university hospital.


RESULTS
Leptin did not relate to fibrinogen (r = 0.11 and 0.13 in women and men respectively; P > 0.05), a relationship with vWF:Ag was only found in men (r = 0.31; P = 0.005), while leptin related to PAI-1 activity in both men (r = 0.36; P < 0.001) and women (r = 0.23; P < 0.001). Further analysis showed leptin to have an effect on the variation of PAI-1 independent of VAT and HOMA-IR in women, but not in men. Multiple regression showed HOMA-IR to be the most important determinant of PAI-1, both in men and women, but leptin also showed an independent effect. As for vWF:Ag, leptin was an independent determinant in men only.


CONCLUSIONS
PAI-1 related to leptin levels independent of fat mass percentage, HOMA-IR, and the amount of VAT and SAT. For vWF:Ag this relationship was found only in men, and not in women, while a relationship with fibrinogen could not be demonstrated.
Mertens
Ilse
I
Department of Diabetology, Metabolism and Clinical Nutrition, Faculty of Medicine, Antwerp Unviersity Hospital, University of Antwerp, Antwerp, Belgium.
Considine
Robert V
RV
Van der Planken
Marc
M
Van Gaal
Luc F
LF
D000273:Adipose Tissue / Q000502:physiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D005260:Female; D005340:Fibrinogen / Q000502:physiology; D005342:Fibrinolysis / Q000502:physiology*; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D020738:Leptin / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed; D014841:von Willebrand Factor / Q000378:metabolism
D020738:Leptin; D017395:Plasminogen Activator Inhibitor 1; D014841:von Willebrand Factor; D005340:Fibrinogen