Inflammatory and prothrombotic parameters in normotensive non-diabetic obese women: effect of weight loss obtained by gastric banding

Intern Emerg Med. 2012 Jun;7(3):237-42. doi: 10.1007/s11739-011-0522-x. Epub 2011 Jan 20.

Abstract

Hypertension and diabetes are known risk factors for obesity-related thrombosis, but several studies have shown that obesity is characterised by a potentially prothrombotic inflammatory state because of activated coagulation and impaired fibrinolysis. In order to verify if obese patients-unaffected by hypertension, diabetes, dyslipidemia, cigarette smoking or inflammatory diseases-show increased prothrombotic markers and whether the weight loss induced by gastric banding normalises such parameters. Plasma levels of C reactive protein (CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (VWF) and factor VII (FVII) were measured in 25 women with isolated obesity prior to, as well as 3, 6 and 12 months subsequent to gastric banding. Twenty-five healthy women served as a baseline control group. The obese women had higher CRP (p = 0.0001), fibrinogen (p = 0.014), PAI-1 (p = 0.003), VWF (p = 0.004) and FVII levels (p = 0.0001) than the normal controls, and their body mass index (BMI) positively correlated with CRP (r = 0.462, p = 0.02), fibrinogen (r = 0.426, p = 0.04) and PAI-1 (r = 0.468, p = 0.02). Twelve months after gastric banding, the median BMI had decreased from 40.0 to 34.9 (p = 0.0001); CRP from 4.18 to 1.69 μg/ml (p = 0.01); fibrinogen from 389 to 318 mg/dl (p = 0.0001); PAI-1 from 32.1 to 12.0 UI/ml (p = 0.003); VWF from 144 to 120% (p = 0.0001); and FVII from 134 to 112% (p = 0.002). Even in the absence of major cardiovascular risk factors, obese patients are characterised by a prothrombotic state. The weight loss induced by gastric banding decreases the parameters of inflammation, coagulation and impaired fibrinolysis, thus potentially reducing the thrombotic risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Coagulation
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Factor VII / metabolism
  • Female
  • Fibrinogen / analysis
  • Gastroplasty*
  • Humans
  • Inflammation / etiology
  • Inflammation / pathology*
  • Inflammation / surgery
  • Middle Aged
  • Obesity / complications
  • Obesity / pathology*
  • Obesity / surgery
  • Plasminogen Activator Inhibitor 1 / metabolism
  • Risk Factors
  • Statistics, Nonparametric
  • Weight Loss*
  • Women's Health*
  • von Willebrand Factor / analysis
  • von Willebrand Factor / metabolism

Substances

  • Plasminogen Activator Inhibitor 1
  • von Willebrand Factor
  • Factor VII
  • Fibrinogen
  • C-Reactive Protein