title: Hypercoagulability in overweight and obese subjects who are asymptomatic for thrombotic events.
abstract: The role of circulating microparticles (MP) of different origin and tissue factor (TF)-bearing in overweight and obese patients with and without metabolic syndrome is still a matter of debate. In a case-control study, the presence of hypercoagulability was evaluated in overweight and obese patients by measuring MP, thrombin generation (TG) and FVIIa-AT complexes. Twenty overweight patients (body mass index [BMI] range 25-29.9 kg/m²), 20 with I degree (30-34.9 kg/m²), 20 with II degree (35-39.9 kg/m²) and 20 with III degree obesity (≥ 40 kg/m²) were enrolled and compared to 40 age and gender-matched normal weight individuals. A significant increase in median levels of all MP subtypes was observed in the three degrees of obese patients compared to controls. Overweight patients had higher levels of annexin V-MP (AMP), endothelial-derived, leukocyte-derived and TF-bearing MP than controls. Obese patients had a significantly shorter median lag time (p< 0.05), higher median peak thrombin (p< 0.01) and increased median endogenous thrombin potential [ETP] (p< 0.001) compared to controls. Overweight subjects had significantly increased ETP compared to controls (p< 0.05). Both AMP levels and ETP were found to positively correlate with BMI, waist circumference, and inflammatory parameters. No significant increase in FVIIa-AT complex was seen in cases compared to controls. We conclude that obesity is associated with overproduction of procoagulant MP and increase TG. Interestingly, hypercoagulability is found in overweight patients free of metabolic syndrome and increases with the severity of obesity. Assessment of MP and TG may be helpful in the early characterisation of the prothrombotic state in obese patients.
authors.forename: Elena
authors.initials: E
authors.lastname: Campello
authors.forename: Eva
authors.initials: E
authors.lastname: Zabeo
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Radu
authors.forename: Luca
authors.initials: L
authors.lastname: Spiezia
authors.forename: Sabrina
authors.initials: S
authors.lastname: Gavasso
authors.forename: Mariangela
authors.initials: M
authors.lastname: Fadin
authors.forename: Barry
authors.initials: B
authors.lastname: Woodhams
authors.forename: Roberto
authors.initials: R
authors.lastname: Vettor
authors.affiliation: Paolo Simioni, Department of Cardiologic, Thoracic and Vascular Sciences, and Department of Medicine, University of Padua, Via Ospedale Civile 105, 35100 Padua, Italy, Tel.: +39 049 8212667, Fax: +39 049 8212651, E-mail: paolo.simioni@unipd.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Simioni
mesh_terms: D000328:Adult; D000991:Antithrombins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D015992:Body Mass Index; D016022:Case-Control Studies; D055252:Cell-Derived Microparticles / Q000378:metabolism; D003430:Cross-Sectional Studies; D015942:Factor VIIa / Q000378:metabolism; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D050177:Overweight / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013917:Thrombin / Q000378:metabolism; D019851:Thrombophilia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D013925:Thromboplastin / Q000378:metabolism; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D055105:Waist Circumference
chemical_list: D000991:Antithrombins; D015415:Biomarkers; D018836:Inflammation Mediators; D013925:Thromboplastin; D015942:Factor VIIa; D013917:Thrombin
keywords: Hypercoagulability; microparticles; obesity; thrombin generation; tissue factor