Platelet Counts and Liver Enzymes After Gastric Bypass Surgery

Johansson, Hans-Erik; Wåhlén, Anna; Aldenbäck, Erica; Haenni, Arvo

doi:10.1007/s11695-017-3035-5

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…Platelet size and platelet count were correlated inversely, in accordance with small scale studies [ 17 ], and showed associations with BMI in opposite directions. This is in accordance with opposite changes, a reduction of platelet count and an increase in MPV, after bariatric surgery [ 50 , 51 ] and in association with liver fibrosis [ 45 , 52 ]. The association of BMI with MPV and PDW, however, was inverse only for pre-menopausal women, but was positive for post-menopausal women, as well as for men.…”

Section: Discussionsupporting

confidence: 82%

Sex differences in the associations of body size and body shape with platelets in the UK Biobank cohort

et al. 2023

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Background Obesity is accompanied by low-grade inflammation and leucocytosis and increases the risk of venous thromboembolism. Associations with platelet count, however, are unclear, because several studies have reported positive associations only in women. Associations with body shape are also unclear, because waist and hip circumferences reflect overall body size, as well as body shape, and are correlated strongly positively with body mass index (BMI). Methods We evaluated body shape with the allometric body shape index (ABSI) and hip index (HI), which reflect waist and hip size among individuals with the same weight and height and are uncorrelated with BMI. We examined the associations of BMI, ABSI, and HI with platelet count, mean platelet volume (MPV), and platelet distribution width (PDW) in multivariable linear regression models for 125,435 UK Biobank women and 114,760 men. We compared men with women, post-menopausal with pre-menopausal women, and older (≥ 52 years) with younger (< 52 years) men. Results BMI was associated positively with platelet count in women, more strongly in pre-menopausal than in post-menopausal, and weakly positively in younger men but strongly inversely in older men. Associations of BMI with platelet count were shifted towards the inverse direction for daily alcohol consumption and current smoking, resulting in weaker positive associations in women and stronger inverse associations in men, compared to alcohol ≤ 3 times/month and never smoking. BMI was associated inversely with MPV and PDW in pre-menopausal women but positively in post-menopausal women and in men. ABSI was associated positively with platelet count, similarly in women and men, while HI was associated weakly inversely only in women. ABSI was associated inversely and HI positively with MPV but not with PDW and only in women. Platelet count was correlated inversely with platelet size and positively with leucocyte counts, most strongly with neutrophils. Conclusions Competing factors determine the associations of BMI with platelet count. Factors with sexually dimorphic action (likely thrombopoietin, inflammatory cytokines, or cortisol), contribute to a positive association, more prominently in women than in men, while age-dependent factors (likely related to liver damage and fibrosis), contribute to an inverse association, more prominently in men than in women.

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Section: Discussionsupporting

confidence: 82%

Sex differences in the associations of body size and body shape with platelets in the UK Biobank cohort

et al. 2023

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“…In our patients with obesity, we observed a significant decrease of all biochemical and metabolic parameters assayed after bariatric surgery, clearly showing that LSG was effective in improving serum cytokine and the adipocytokine profile, thus ameliorating systemic inflammatory and metabolic status [43, 44]. We noted a statistically significant reduction of platelet count, as Johansson et al [45] also showed in 124 morbidly obese non-diabetic patients 12 months after Roux-en Y gastric bypass. In our population this decrease was not evident in ob T2DM, perhaps due to a more severe inflammation state and a higher degree of fibrosis than the ob N and ob preDM subgroups, which also persisted after surgery.…”

Section: Discussionsupporting

confidence: 75%

SCCA-IgM as a Potential Biomarker of Non-Alcoholic Fatty Liver Disease in Patients with Obesity, Prediabetes and Diabetes Undergoing Sleeve Gastrectomy

et al. 2019

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Background: Non-alcoholic fatty liver disease (NAFLD) has a high prevalence in obesity and its presence should be screened. Laparoscopic sleeve gastrectomy (LSG) is an effective treatment for obesity, but its effects on NAFLD are still to be firmly established. The diagnosis of non-alcoholic steatohepatitis (NASH) is currently performed by liver biopsy, a costly and invasive procedure. Squamous cell carcinoma antigen-IgM (SCCA-IgM) is a biomarker of viral hepatitis to hepatocellular carcinoma development and its role in NAFLD to NASH progression has not yet been investigated. Objective: The aim of this study was to evaluate SCCA-IgM as a non-invasive biomarker of NAFLD/NASH in patients with different degrees of metabolic-complicated obesity before and after LSG. Method: Fifty-six patients with obesity were studied before and 12 months after LSG; anthropometric, biochemical, clinical, and imaging data were collected. Results: At baseline steatosis was strongly associated with the glycaemic profile (p = 0.016) and was already present in prediabetic patients with obesity (82%). Only 3 patients had an SCCA-IgM level above the normal cut-off. SCCA-IgM titre did not change according to glycaemic profile or steatosis. Metabolic and inflammatory factors and transaminases significantly reduced after LSG-induced weight loss, except for SCCA-IgM. The ALT/AST ratio decreased post-LSG correlated with BMI (r = 0.297, p = 0.031), insulin (r = 0.354, p = 0.014), and triglycerides (r = 0.355, p = 0.009) reduction. Conclusions: Our results confirm the tight link between NAFLD and metabolic complications, suggesting prediabetes as a new risk factor of steatosis. SCCA-IgM does not seem to have a role in the identification and prognosis of NAFLD.

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“…However, statins raise BMI in both sexes (Table 1 ), while genetically mimicked effects on calcium and SHBG were specific to women, suggesting a more complex explanation. A trial of gastric bypass suggested that BMI increases platelet count [ 56 ] but genetically predicted BMI does not appear to affect platelet count in women (Additional file 1 : Table S14). However, BMI is well-known to play a crucial role in BMR in both sexes [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

A phenome-wide association study of genetically mimicked statins

Schooling

2021

BMC Med

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Background Beyond their success in cardiovascular disease prevention, statins are increasingly recognized to have sex-specific pleiotropic effects. To gain additional insight, we characterized associations of genetically mimicked statins across the phenotype sex-specifically. We also assessed whether any apparently non-lipid effects identified extended to genetically mimicking other widely used lipid modifiers (proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and ezetimibe) or were a consequence of low-density lipoprotein cholesterol (LDL-c). Methods We performed a sex-specific phenome-wide association study assessing the association of genetic variants in HMGCR, mimicking statins, with 1701 phenotypes. We used Mendelian randomization (MR) to assess if any non-lipid effects found were evident for genetically mimicked PCSK9 inhibitors and ezetimibe or for LDL-c. Results As expected, genetically mimicking statins was inversely associated with LDL-c, apolipoprotein B (ApoB), and total cholesterol (TC) and positively associated with glycated hemoglobin (HbA1c) and was related to body composition. Genetically mimicking statins was also inversely associated with serum calcium, sex hormone-binding globulin (SHBG), and platelet count and positively associated with basal metabolic rate (BMR) and mean platelet volume. Stronger associations with genetically mimicked statins were evident for women than men for lipid traits (LDL-c, ApoB, and TC), calcium, and SHBG, but not for platelet attributes, body composition, or BMR. Genetically mimicking PCSK9 inhibitors or ezetimibe was also associated with lower lipids, but was not related to calcium, SHBG, BMR, or body composition. Genetically higher LDL-c increased lipids and decreased BMR, but did not affect calcium, HbA1c, platelet attributes, or SHBG with minor effects on body composition. Conclusions Similar inverse associations were found for genetically mimicking statins on lipid traits in men and women as for other lipid modifiers. Besides the positive associations with HbA1c, BMI (which may explain the higher BMR), and aspects of body composition in men and women, genetically mimicking statins was additionally associated with platelet attributes in both sexes and was inversely associated with serum calcium and SHBG in women. This genetic evidence suggests potential pathways that contribute to the effects of statins particularly in women. Further investigation is needed to confirm these findings and their implications for clinical practice.

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Platelet Counts and Liver Enzymes After Gastric Bypass Surgery

Cited by 10 publications

References 34 publications

Sex differences in the associations of body size and body shape with platelets in the UK Biobank cohort

Sex differences in the associations of body size and body shape with platelets in the UK Biobank cohort

SCCA-IgM as a Potential Biomarker of Non-Alcoholic Fatty Liver Disease in Patients with Obesity, Prediabetes and Diabetes Undergoing Sleeve Gastrectomy

A phenome-wide association study of genetically mimicked statins

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