Hypercoagulability in overweight and obese subjects who are asymptomatic for thrombotic events

Elena Campello; Eva Zabeo; Claudia M. Radu; Luca Spiezia; Sabrina Gavasso; Mariangela Fadin; Barry Woodhams; Roberto Vettor; Paolo Simioni

doi:10.1160/TH14-02-0156

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2015; 113(01): 85-96
DOI: 10.1160/TH14-02-0156

Coagulation and Fibrinolysis

Schattauer GmbH

Hypercoagulability in overweight and obese subjects who are asymptomatic for thrombotic events

Elena Campello^*

¹Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy

²Department of Medicine (DIMED), University of Padua, Padua, Italy

,

Eva Zabeo^*

²Department of Medicine (DIMED), University of Padua, Padua, Italy

,

Claudia M. Radu

¹Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy

²Department of Medicine (DIMED), University of Padua, Padua, Italy

,

Luca Spiezia

¹Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy

²Department of Medicine (DIMED), University of Padua, Padua, Italy

,

Sabrina Gavasso

¹Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy

²Department of Medicine (DIMED), University of Padua, Padua, Italy

,

Mariangela Fadin

¹Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy

²Department of Medicine (DIMED), University of Padua, Padua, Italy

,

Barry Woodhams

¹Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy

³HaemaCon Ltd, Bromley, UK

,

Roberto Vettor

²Department of Medicine (DIMED), University of Padua, Padua, Italy

,

Paolo Simioni

¹Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy

²Department of Medicine (DIMED), University of Padua, Padua, Italy

› Institutsangaben

Abstract

Summary

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.

Keywords

Hypercoagulability - microparticles - obesity - thrombin generation - tissue factor

Volltext

Referenzen

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