title: Plasminogen activator inhibitor 1 and visceral obesity during pronounced weight loss after bariatric surgery.
abstract: OBJECTIVE
  Elevated plasminogen activator inhibitor 1 (PAI-1) concentrations are a hallmark of obesity and are considered to contribute to the development of cardiovascular disease. As adipose tissue constitutes a major source for PAI-1 in obesity, we investigated the individual contribution of subcutaneous and intra-abdominal fat on PAI-1 concentrations during pronounced weight loss after bariatric surgery.
  
  
  RESULTS
  Thirty-seven obese adults were examined before and 18 months after surgery. Abdominal fat distribution was determined by ultrasound, metabolic parameters and plasma PAI-1 levels by standard methods. BMI was reduced by 9.2 ± 4.9 kg/m(2), while total fat mass and visceral fat diameter (VFD) decreased by 20.7 ± 11.9 kg and 4.2 ± 2.3 cm, respectively. Concomitantly, PAI-1 levels diminished by 3.2 ± 5.6 ng/ml (all p ≤ 0.015). Change in PAI-1 levels was correlated with change in VFD (r = 0.441, p = 0.008), but not with subcutaneous fat diameter. In stepwise multiple regression analysis change in VFD was an independent predictor of change in PAI-1 concentrations. When adjusted for age and sex or total fat mass associations between PAI-1 and VFD remained significant.
  
  
  CONCLUSIONS
  We demonstrate that VFD is a major determinant for PAI-1 concentrations during pronounced weight loss after bariatric surgery. Thus, significant reduction of visceral fat mass may contribute to the reduced cardiovascular morbidity and mortality after bariatric surgery by a concomitant decrease in PAI-1 concentrations.
authors.affiliation: Department of Internal Medicine I, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Tschoner
authors.forename: W
authors.initials: W
authors.lastname: Sturm
authors.forename: J
authors.initials: J
authors.lastname: Engl
authors.forename: S
authors.initials: S
authors.lastname: Kaser
authors.forename: M
authors.initials: M
authors.lastname: Laimer
authors.forename: E
authors.initials: E
authors.lastname: Laimer
authors.forename: A
authors.initials: A
authors.lastname: Klaus
authors.forename: J R
authors.initials: JR
authors.lastname: Patsch
authors.forename: C F
authors.initials: CF
authors.lastname: Ebenbichler
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000097:blood*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011446:Prospective Studies; D015431:Weight Loss
chemical_list: D008078:Cholesterol, LDL; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human