title: Weight loss reduces anti-ADAMTS13 autoantibodies and improves inflammatory and coagulative parameters in obese patients.
abstract: Obese patients have been described at increased risk of thrombotic thrombocytopenic purpura, a disease caused by anti-ADAMTS13 autoantibodies. ADAMTS13 has a structure homology with the adipokine thrombospondin-1. We previously demonstrated an increased presence of anti-ADAMTS13 antibodies in obese patients. We aimed to study the changes induced by weight loss after bariatric surgery on some inflammatory and coagulative parameters and their link with anti-ADAMTS13 autoantibodies. We studied 100 obese patients before and after weight loss induced by bariatric surgery and 79 lean volunteers as controls. We measured anthropometric, metabolic and inflammatory parameters, thrombospondin-1, ADAMTS13 activity, anti-ADAMTS13 autoantibodies, Von Willebrand factor. At baseline, 13 % of patients was positive for anti-ADAMTS13 autoantibodies, while all controls were negative. Thrombospondin-1 levels were higher in obese subjects with than without antibodies, with a positive correlation between the two parameters. In multiple logistic regression analysis only thrombospondin-1 levels predicted positivity for anti-ADAMTS13 antibodies. After weight loss both anti-ADAMTS13 antibodies and thrombospondin-1 reduced significantly. Weight loss in obesity improves the inflammatory and coagulative profile, and in particular anti-ADAMTS13 autoantibodies, ADAMTS13 activity and thrombospondin-1.
authors.affiliation: Department of Medicine-DIMED, University of Padova, Internal Medicine 3, Padova, Italy. veronica.zanato@hotmail.it.
authors.forename: Veronica
authors.initials: V
authors.lastname: Zanato
authors.affiliation: Department of Medicine-DIMED, University of Padova, Internal Medicine 1, Padova, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Lombardi
authors.affiliation: Department of Medicine-DIMED, University of Padova, Internal Medicine 3, Padova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Busetto
authors.affiliation: Department of Medicine-DIMED, University of Padova, Internal Medicine 3, Padova, Italy.
authors.forename: Chiara Dal
authors.initials: CD
authors.lastname: Prà
authors.affiliation: Week Surgery, Hospital Establishment of Padova, Padova, Italy.
authors.forename: Mirto
authors.initials: M
authors.lastname: Foletto
authors.affiliation: Week Surgery, Hospital Establishment of Padova, Padova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Prevedello
authors.affiliation: Critical Area Department, Emergency Room Unit, Treviso, Montebelluna, Italy.
authors.forename: Giulia Berti
authors.initials: GB
authors.lastname: De Marinis
authors.affiliation: Department of Medicine-DIMED, University of Padova, Internal Medicine 1, Padova, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fabris
authors.affiliation: Department of Medicine-DIMED, University of Padova, Internal Medicine 3, Padova, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Vettor
authors.affiliation: Department of Medicine-DIMED, University of Padova, Internal Medicine 3, Padova, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Fabris
mesh_terms: D000071120:ADAMTS13 Protein / Q000276:immunology*; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001777:Blood Coagulation / Q000502:physiology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000276:immunology*; D015431:Weight Loss / Q000502:physiology*
chemical_list: D001323:Autoantibodies; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human
keywords: Anti-ADAMTS13 Autoantibodies; Obesity; TTP; Thrombospondin-1