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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   *
1   Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy
2   Department of Medicine (DIMED), University of Padua, Padua, Italy
,
Eva Zabeo   *
2   Department of Medicine (DIMED), University of Padua, Padua, Italy
,
Claudia M. Radu
1   Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy
2   Department of Medicine (DIMED), University of Padua, Padua, Italy
,
Luca Spiezia
1   Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy
2   Department of Medicine (DIMED), University of Padua, Padua, Italy
,
Sabrina Gavasso
1   Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy
2   Department of Medicine (DIMED), University of Padua, Padua, Italy
,
Mariangela Fadin
1   Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy
2   Department of Medicine (DIMED), University of Padua, Padua, Italy
,
Barry Woodhams
1   Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy
3   HaemaCon Ltd, Bromley, UK
,
Roberto Vettor
2   Department of Medicine (DIMED), University of Padua, Padua, Italy
,
Paolo Simioni
1   Department of Cardiologic, Thoracic and Vascular Sciences (DCTV), University of Padua, Padua, Italy
2   Department of Medicine (DIMED), University of Padua, Padua, Italy
› Author Affiliations
Further Information

Publication History

Received: 19 February 2014

Accepted after major revision: 04 September 2014

Publication Date:
27 November 2017 (online)

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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

* These authors equally contributed to the study.


 

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