Inflammatory and prothrombotic parameters in normotensive non-diabetic obese women: effect of weight loss obtained by gastric banding.
Hypertension and diabetes are known risk factors for obesity-related thrombosis, but several studies have shown that obesity is characterised by a potentially prothrombotic inflammatory state because of activated coagulation and impaired fibrinolysis. In order to verify if obese patients-unaffected by hypertension, diabetes, dyslipidemia, cigarette smoking or inflammatory diseases-show increased prothrombotic markers and whether the weight loss induced by gastric banding normalises such parameters. Plasma levels of C reactive protein (CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (VWF) and factor VII (FVII) were measured in 25 women with isolated obesity prior to, as well as 3, 6 and 12 months subsequent to gastric banding. Twenty-five healthy women served as a baseline control group. The obese women had higher CRP (p = 0.0001), fibrinogen (p = 0.014), PAI-1 (p = 0.003), VWF (p = 0.004) and FVII levels (p = 0.0001) than the normal controls, and their body mass index (BMI) positively correlated with CRP (r = 0.462, p = 0.02), fibrinogen (r = 0.426, p = 0.04) and PAI-1 (r = 0.468, p = 0.02). Twelve months after gastric banding, the median BMI had decreased from 40.0 to 34.9 (p = 0.0001); CRP from 4.18 to 1.69 μg/ml (p = 0.01); fibrinogen from 389 to 318 mg/dl (p = 0.0001); PAI-1 from 32.1 to 12.0 UI/ml (p = 0.003); VWF from 144 to 120% (p = 0.0001); and FVII from 134 to 112% (p = 0.002). Even in the absence of major cardiovascular risk factors, obese patients are characterised by a prothrombotic state. The weight loss induced by gastric banding decreases the parameters of inflammation, coagulation and impaired fibrinolysis, thus potentially reducing the thrombotic risk.
Department of Internal Medicine, University of Milan, Milan, Italy. massimo.cugno@unimi.it
Massimo
M
Cugno
Roberto
R
Castelli
Daniela
D
Mari
Enrico
E
Mozzi
Marco Antonio
MA
Zappa
Massimo
M
Boscolo-Anzoletti
Giancarlo
G
Roviaro
Pier Mannuccio
PM
Mannucci
D000328:Adult; D001777:Blood Coagulation; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D005167:Factor VII / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D015391:Gastroplasty; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000473:pathology* / Q000601:surgery; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015431:Weight Loss; D016387:Women's Health; D014841:von Willebrand Factor / Q000032:analysis / Q000378:metabolism
D017395:Plasminogen Activator Inhibitor 1; D014841:von Willebrand Factor; D005167:Factor VII; D005340:Fibrinogen; D002097:C-Reactive Protein
Clin Pharmacol Ther. 2010 Apr;87(4):407-16
20200516
Obes Surg. 2010 Apr;20(4):415-22
20077029
Thromb Haemost. 1992 Oct 5;68(4):396-9
1448769
Metabolism. 1990 Oct;39(10):1044-8
2215252
Int J Obes Relat Metab Disord. 1993 Dec;17(12):723-5
8118478
Obes Rev. 2009 Sep;10(5):554-63
19460118
Thromb Haemost. 1993 Sep 1;70(3):380-5
8259533
Semin Thromb Hemost. 2010 Feb;36(1):41-8
20391295
Metabolism. 1986 Mar;35(3):250-3
3081778
Obes Surg. 1995 Feb;5(1):66-70
10733796
Arch Intern Med. 2007 Jan 8;167(1):31-9
17210875
N Engl J Med. 2007 May 24;356(21):2176-83
17522401
Obes Surg. 2010 Apr;20(4):492-9
20127289
Biochem Soc Trans. 2005 Nov;33(Pt 5):1078-81
16246049
Metabolism. 1995 Nov;44(11):1417-21
7476328
Nature. 2006 Dec 14;444(7121):875-80
17167476
Circulation. 2010 Jan 19;121(2):230-6
20038741
Obes Rev. 2002 May;3(2):85-101
12120424
Arterioscler Thromb Vasc Biol. 1996 Mar;16(3):381-5
8630663
Circulation. 2008 Apr 29;117(17):2253-61
18427128
Circulation. 1993 Nov;88(5 Pt 1):2030-4
8222095
Thromb Haemost. 2004 Apr;91(4):683-9
15045128
JAMA. 1979 May 11;241(19):2035-8
430798
Circulation. 2000 Jul 4;102(1):42-7
10880413
Circulation. 2004 Jun 8;109(22):2698-704
15184294
N Engl J Med. 1994 Aug 18;331(7):417-24
7880233
Circulation. 1996 Apr 1;93(7):1372-9
8641026
Arterioscler Thromb. 1993 Feb;13(2):162-9
8427853
Nutr Rev. 2005 Jan;63(1):22-8
15730232
Circulation. 2003 Nov 4;108(18):2206-11
14557360
Lancet. 1987 Jul 4;2(8549):3-9
2885513
Lancet. 2010 Jan 9;375(9709):95-6
20031200
Thromb Res. 2004;114(5-6):321-7
15507261
Int J Obes Relat Metab Disord. 1997 Jul;21(7):527-535
9226481