title: Haemostatic alterations in overweight children: associations between metabolic syndrome, thrombin generation, and fibrinogen levels.
abstract: 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.
authors.affiliation: Department of Paediatrics, Medical University of Graz, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Fritsch
authors.forename: M
authors.initials: M
authors.lastname: Kleber
authors.forename: A
authors.initials: A
authors.lastname: Rosenkranz
authors.forename: M
authors.initials: M
authors.lastname: Fritsch
authors.forename: W
authors.initials: W
authors.lastname: Muntean
authors.forename: H
authors.initials: H
authors.lastname: Mangge
authors.forename: T
authors.initials: T
authors.lastname: Reinehr
mesh_terms: 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*
chemical_list: D008055:Lipids; D005340:Fibrinogen; D013917:Thrombin