title: Reduction of coagulability state one year after bariatric surgery.
abstract: BACKGROUND
  Obese patients are in a hypercoagulable state relative to normal-weight patients. Low-grade inflammation may be a key factor for this condition.
  
  
  OBJECTIVE
  Our study aimed to compare the coagulability state of morbidly obese patients before and 1 year after bariatric surgery (BS) using the Thrombin Generation (TG) test, a validated method to assess coagulation in vitro.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  All patients undergoing BS between September 1, 2014 and April 30, 2015 were eligible for this prospective study (n = 42). Two distinct reagents were used for TG initiation based on the tissue factor concentration (Reagents LOW and HIGH). The main outcomes were endogenous thrombin potential (ETP) and peak height of TG. The rate of follow-up after one year was 97%.
  
  
  RESULTS
  One year after surgery, %weight loss was 32.5±8.4%; CRP decreased from 9.0 (3.7-12.9) to 1.1 (0.3-2.8) mg/mL (P<.001) and fibrinogen from 4.2±.8 to 3.5±.8 g/L (P<.001). The ETP (%) decreased from (108.0 (95.0-117.0) to 78.0 (71.0-98.0) (P<.001) (LOW reagent) and from 113.0 (103.0-134.0) to 96.0 (86.0-107.0) (P<.001) (HIGH reagent). Peak height (%) decreased from (117.0 (92.0-139.0) to 82.0 (70.0-111.0) (P = .003) (LOW reagent) and from 106.0 (96.0-118.0) to 97.0 (87.8-105.2) (P = .003) (HIGH reagent).
  
  
  CONCLUSIONS
  Our study shows a significant reduction in TG potential one year after BS in morbidly obese patients. Reduction of low grade inflammation may be one of the underlying mechanisms.
authors.affiliation: Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, Brest, France; University of Bretagne Occidentale (UBO), EA 3878 (GETBO), Brest, France. Electronic address: jeremie.thereaux@chu-brest.fr.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Thereaux
authors.affiliation: Laboratory of Hemostasis, La Cavale Blanche University Hospital, Brest, France; University of Bretagne Occidentale (UBO), EA 3878 (GETBO), Brest, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Mingant
authors.affiliation: Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, Brest, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Roche
authors.affiliation: University of Bretagne Occidentale (UBO), EA 3878 (GETBO), Brest, France; Laboratory of Hemostasis, La Cavale Blanche University Hospital, Brest, France.
authors.forename: Hubert
authors.initials: H
authors.lastname: Galinat
authors.affiliation: University of Bretagne Occidentale (UBO), EA 3878 (GETBO), Brest, France; Department of Internal Medicine, La Cavale Blanche University Hospital, Brest, France; INSERM, CIC1412 (FC, KL), La Cavale Blanche University Hospital, Brest, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Couturaud
authors.affiliation: University of Bretagne Occidentale (UBO), EA 3878 (GETBO), Brest, France; Department of Internal Medicine, La Cavale Blanche University Hospital, Brest, France; INSERM, CIC1412 (FC, KL), La Cavale Blanche University Hospital, Brest, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Lacut
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D001780:Blood Coagulation Tests / Q000379:methods; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D011182:Postoperative Care; D011446:Prospective Studies; D013917:Thrombin / Q000378:metabolism; D019851:Thrombophilia / Q000097:blood / Q000517:prevention & control* / Q000601:surgery; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
chemical_list: D005340:Fibrinogen; D002097:C-Reactive Protein; D013917:Thrombin
keywords: Bariatric surgery; coagulability; thrombin generation