Haemostatic alterations in overweight children: associations between metabolic syndrome, thrombin generation, and fibrinogen levels.
BACKGROUND
The metabolic syndrome (MetS) is associated with central obesity and leads to increased morbidity and mortality due to cardiovascular disease (CVD). Since obesity is associated with a hypercoagulable state, it has been speculated that hypercoagulation is linking MetS to CVD.


METHODS
We prospectively examined 81 overweight children and 32 normal-weight children aged 10-16 years. We analyzed blood pressure, fasting lipids, glucose, insulin, fibrinogen, and thrombin generating test determining time to peak (TTPeak), peak, time preceding the thrombin burst (lag-time), and 'endogenous' thrombin potential (ETP).


RESULTS
Overweight children demonstrated significantly higher fibrinogen levels (p<0.001), shorter lag-time (p<0.001), and TTPeak (p=0.038) compared to normal-weight children. Furthermore, ETP (p<0.001) and peak (p<0.001) were significantly higher in overweight than in normal-weight children. Fibrinogen and all parameters of the clotting test correlated significantly (p always <0.05) to body mass index (BMI) but not significantly to insulin resistance index HOMA-IR or occurrence of MetS in multiple linear backward regression analyses adjusted for age and gender.


CONCLUSIONS
The increased fibrinogen levels and the changes in the thrombin generation test points towards a haemostatic alteration in overweight children. The parameters of the clotting test were related to the degree of overweight but not to insulin resistance or occurrence of MetS questioning a direct association between MetS and the coagulation system. Longitudinal studies are needed to confirm these findings.
Fritsch
P
P
Department of Paediatrics, Medical University of Graz, Austria.
Kleber
M
M
Rosenkranz
A
A
Fritsch
M
M
Muntean
W
W
Mangge
H
H
Reinehr
T
T
D000293:Adolescent; D001794:Blood Pressure; D001835:Body Weight; D002648:Child; D005260:Female; D005340:Fibrinogen / Q000096:biosynthesis*; D006487:Hemostasis; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000737:chemistry; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D009765:Obesity; D050177:Overweight / Q000097:blood*; D011446:Prospective Studies; D013917:Thrombin / Q000096:biosynthesis*
D008055:Lipids; D005340:Fibrinogen; D013917:Thrombin