title: Primary antiphospholipid antibody syndrome-one further aspect of thrombophilia in overweight and obese patients with venous thromboembolism.
abstract: OBJECTIVE
  Overweight and obesity are established risk factors for venous thromboembolism (VTE). We examined the difference in the frequency of primary antiphospholipid antibody syndrome (PAPS) in VTE patients according to their BMI.
  
  
  METHODS
  We included 998 VTE patients treated at our institution between 2009 and 2011 in a retrospective data analysis. Thrombophilia screening including evaluation for APS (lupus anticoagulant, anti-cardiolipin, and anti-B2-glycoprotein-I IgG and IgM antibodies) was performed in all patients.
  
  
  RESULTS
  PAPS was diagnosed in 6.8% (24/355) of normal weight (BMI < 24 kg/m2) VTE patients, in 11.1% (50/452) of overweight (BMI 25-30 kg/m2) VTE patients, and in 15.7% (30/191) of obese (BMI > 31 kg/m2) VTE patients. The difference of PAPS occurrence between these groups was statistically significant (P = 0.001). PAPS patients demonstrated higher fibrinogen levels as compared to non-PAPS patients (median 416.0 md/dl vs. 352.0 mg/dl, P = 0.001). Furthermore, fibrinogen levels increased significantly according to the body weight of patients (median normal weight patients 330.0 mg/dl vs. overweight patients 359.0 mg/dl vs. obese patients 415.0 mg/dl, P = 0.001).
  
  
  CONCLUSIONS
  PAPS seems to be more frequent in overweight and obese patients. As PAPS patients showed significantly higher fibrinogen levels and as fibrinogen levels increased significantly according to the body weight of patients, an elevated inflammatory state in overweight and obese patients as a reason for the increased PAPS occurrence can be assumed.
authors.affiliation: Division of Angiology, Department of Internal Medicine, Medical University Graz, Graz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gary
authors.forename: Klara
authors.initials: K
authors.lastname: Belaj
authors.forename: Rosa
authors.initials: R
authors.lastname: Bruckenberger
authors.forename: Gerald
authors.initials: G
authors.lastname: Hackl
authors.forename: Franz
authors.initials: F
authors.lastname: Hafner
authors.forename: Harald
authors.initials: H
authors.lastname: Froehlich
authors.forename: Armin
authors.initials: A
authors.lastname: Zebisch
authors.forename: Ernst
authors.initials: E
authors.lastname: Pilger
authors.forename: Marianne
authors.initials: M
authors.lastname: Brodmann
mesh_terms: D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000276:immunology; D050177:Overweight / Q000097:blood / Q000150:complications / Q000276:immunology; D012189:Retrospective Studies; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood / Q000209:etiology* / Q000276:immunology; D054556:Venous Thromboembolism / Q000097:blood / Q000209:etiology* / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid; D005340:Fibrinogen