title: Alterations in the common pathway of coagulation during weight loss induced by gastric bypass in severely obese patients.
abstract: The objective of this study was to establish the relationship between the plasminogen activator inhibitor-1 (PAI-1), antithrombin-III (ATIII), fibrinogen, and white blood cell (WBC) levels in severely obese patients. We analyzed various plasma parameters implicated in the intrinsic and extrinsic coagulation pathway from 34 severely obese patients before and 1, 6, and 12 months after gastric bypass. In obese people, ATIII, fibrinogen, and WBC levels were in the upper limit of the normal range, and all were higher and significantly different from nonobese people. After bariatric surgery, the ATIII level continued to be high during the first month and increased until 12 months, while fibrinogen decreased only at that time. PAI-1 plasma protein and PAI-1 mRNA levels in liver and adipose tissue show similar profiles and had a strong positive correlation (r = 0.576, P = 0.0003 in liver; r = 0.433, P = 0.0004 in adipose tissue). They were higher in obese patients compared with nonobese control, but tended to recover normal values 1 month after surgery. Thus, the liver and adipose tissue could be an important source of PAI-1 protein in plasma. Gastric bypass surgery leads to a normalization of the hematological profile and a decrease in PAI-1 levels, which entails a decrease of risk for thromboembolism in severely obese.
authors.affiliation: Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Pardina
authors.forename: Roser
authors.initials: R
authors.lastname: Ferrer
authors.forename: Joaquín
authors.initials: J
authors.lastname: Rivero
authors.forename: Juan A
authors.initials: JA
authors.lastname: Baena-Fustegueras
authors.forename: Albert
authors.initials: A
authors.lastname: Lecube
authors.forename: Jose M
authors.initials: JM
authors.lastname: Fort
authors.forename: Víctor
authors.initials: V
authors.lastname: Vargas
authors.forename: Roberto
authors.initials: R
authors.lastname: Catalán
authors.forename: Julia
authors.initials: J
authors.lastname: Peinado-Onsurbe
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D000990:Antithrombin III / Q000378:metabolism*; D001777:Blood Coagulation; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D015390:Gastric Bypass; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000276:immunology / Q000601:surgery; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012307:Risk Factors; D013923:Thromboembolism / Q000378:metabolism / Q000517:prevention & control; D013997:Time Factors; D015431:Weight Loss
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D000990:Antithrombin III; D005340:Fibrinogen