Relationship between Insulin Resistance and Some Coagulation and Fibrinolytic Parameters in Patients with Metabolic Syndrome

Ragab, Amany; Abousamra, Nashwa K.; Higazy, A.; Saleh, Omayma

doi:10.1532/lh96.07017

Cited by 17 publications

(15 citation statements)

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“…In this study, insulin resistance (HOMA-IR) correlated with Antithrombin III, heparin cofactor 2, P-selectin, bronectin, vitamin K dependent protein S and alpha 2 antiplasmin. It is recognized that insulin resistance is associated with enhanced thrombogenesis (24); however, it is di cult to determine the contribution of insulin resistance alone to its association with obesity and in ammation metabolic syndrome lipid parameters (25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Metabolic Consequences Of Obesity On The Hypercoagulable State Of Polycystic Ovary Syndrome: A Risk For Severe SARS-Cov-2 Infection?

Moin¹,

Sathyapalan²,

Diboun³

et al. 2020

Preprint

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Introduction: Polycystic ovary syndrome (PCOS) women have a hypercoagulable state and are also at high risk for severe COVID-19 leading to thromboembolic complications and increased mortality; however, whether this is intrinsically due to PCOS or, alternatively, a consequence of its metabolic complications is unclear. Methods: We determined plasma coagulation pathway protein levels in PCOS (n=146) and control (n=97) women recruited to a PCOS biobank. Circulating levels of a panel of 18 clotting pathway proteins were determined by Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement.Results: Cohorts were age matched, though PCOS had elevated body mass index (BMI)(p<0.001), insulin (p<0.001) and C-reactive protein (CRP)(p<0.0001). Eight pro-coagulation proteins were elevated in PCOS: plasminogen activator inhibitor-1 (PAI-1)(p<0.0001), fibrinogen (p<0.01), fibrinogen gamma chain (p<0.0001), fibronectin (p<0.01), von Willebrand factor (p<0.05), D-dimer (p<0.0001), P-selectin (p<0.05), and plasma kallikrein (p<0.001). However, two anticoagulant proteins, vitamin K-dependent protein-S (p<0.0001) and heparin cofactor-II (p<0.001) were elevated and prothrombin was decreased (p<0.05). CRP, as a marker of inflammation, and insulin resistance (HOMA-IR) correlated with 11 and 6 of the clotting proteins, respectively (p<0.05). When matched for BMI<25 (16 PCOS, 53 controls) HOMA-IR remained elevated (p<0.05) and heparin cofactor-II was increased (p<0.05). In a multivariate analysis accounting for inflammation, insulin resistance and BMI, there was no correlation of PCOS with any of the coagulation proteins.Conclusion: The hypercoagulable State in PCOS can be fully accounted for by BMI, inflammation and insulin resistance suggesting that only obese PCOS women would be predisposed to an enhanced risk for severe COVID-19-related disease.

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Section: Discussionmentioning

confidence: 99%

Metabolic Consequences Of Obesity On The Hypercoagulable State Of Polycystic Ovary Syndrome: A Risk For Severe SARS-Cov-2 Infection?

Moin¹,

Sathyapalan²,

Diboun³

et al. 2020

Preprint

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“…В ряде исследований продемонстрировано повышение активности FVIII при МС, а также ее взаимосвязь с показателями инсулинорезистентности [7,33,41]. В проведенном нами исследовании повышения активности FVIII среди обследованных женщин выявлено не было, однако у 10,9% отмечалось ее клинически незначимое снижение, а у 2 пациенток (3,6%) -значительное снижение, требующее более углубленного уточнения.…”

Section: Discussionunclassified

“…Авторы объясняют полученные данные как возможный механизм компенсации гипофибринолиза, имеющего место при МС. В ряде других исследований значимых взаимосвязей активности системы протеина С с ожирением и МС выявлено не было [33,37,39]. Существуют также данные, свидетельствующие о том, что период постменопаузы ассоциирован со снижением активности антикоагулянтной системы протеина С, что может быть обусловлено увеличением резистентности к активированному протеину С (не связанной с мутацией Лейдена фактора коагуляции V) и/или снижением активности протеина S [26,38].…”

Section: Discussionunclassified

Rasprostranennost' narusheniy svertyvayushchey i protivosvertyvayushchey sistem krovi u zhenshchin s metabolicheskim sindromom v postmenopauze

Berkovskaya¹,

Бутрова²

2010

Obes. metabol.

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The object of the study was to assess the prevalence of prothrombotic alterations in coagulant and anticoagulant systems among postmenopausal women with metabolic syndrome and to determine the associations between these abnormalities and main anthropometric measures and parameters of glucose and lipid metabolism. Cross-sectional observational study included 55 postmenopausal women (age 45-65) with metabolic syndrome. Coagulant system was assessed by measurement of parameters of plasma haemostasis (prothrombin index, Activated Partial Thromboplastin Time (APTT), thrombin time, fibrinogen concentration), and the activities of coagulant factors VII (FVII) and VIII (FVIII) in plasma. In order to investigate the functioning of anticoagulant system the activities of antithrombin III and anticoagulant system of protein C were measured. Prothrombotic alterations were observed in 81,5% women. The APTT was decreased in 14,5%, hyperfibrinogenemia was revealed in 42,6%, the increased activity of FVII - in 50,9%, and the decreased activity of protein C system - in 23,9%. There were a significant positive associations between some of revealed prothrombotic alterations and anthropometric and biochemical markers of visceral obesity and metabolic syndrome (parameters of glucose and lipid metabolism). There were no any associations between haemostatic indices and age. In conclusion, there is an evidence of high prevalence of different prothrombotic alterations in coagulant and anticoagulant systems among postmenopausal women with metabolic syndrome. Metabolic syndrome in postmenopause is associated with the development of prothrombotic state independently of age.

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“…По данным литературы последних лет, МС и ассоциированная с ним инсулинорезистентность сопровождаются повышением уровней факторов VIII и vWF в плазме крови, при этом их содержание положительно коррелирует с индексом инсулинорезистентности НОМА-R [3,14,15]. Поскольку основным источником vWF в плазме является эндотелий, повышение содержания этого фактора можно расценивать как индикатор эндотелиальной дисфункции у пациентов с инсулинорезистентностью и МС [15]. Помимо vWF , маркерами повреждения и дисфункции эндотелия при МС служат повышенные уровни тканевого фактора (ТФ, или фактор III) и t-PA [3,15].…”

Section: метаболический синдром и факторы коагуляционного гемостазаunclassified

“…Поскольку основным источником vWF в плазме является эндотелий, повышение содержания этого фактора можно расценивать как индикатор эндотелиальной дисфункции у пациентов с инсулинорезистентностью и МС [15]. Помимо vWF , маркерами повреждения и дисфункции эндотелия при МС служат повышенные уровни тканевого фактора (ТФ, или фактор III) и t-PA [3,15].…”

Section: метаболический синдром и факторы коагуляционного гемостазаunclassified

Metabolic syndrome as a prothrombogenic state

Berkovskaya¹,

Бутрова²

2009

Obes. metabol.

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The prevalence of obesity has reached epidemic proportions nowadays. Abdominal obesity is the most unfavorable one, because of its association with the complex of markers and risk factors ofcardiovascular diseases and type 2 diabetes mellitus, which is called metabolic syndrome (MS). MS also increases risk of atherothrombosis because it is characterized by low fibrinolysis and prothrombogenic changes in coagulation and platelet hemostasis. The review highlights the mechanisms of hemostatic disturbances in MS, which eхends our scientific knowledge about pathogenesis of cardio vascular diseases

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Relationship between Insulin Resistance and Some Coagulation and Fibrinolytic Parameters in Patients with Metabolic Syndrome

Cited by 17 publications

References 0 publications

Metabolic Consequences Of Obesity On The Hypercoagulable State Of Polycystic Ovary Syndrome: A Risk For Severe SARS-Cov-2 Infection?

Metabolic Consequences Of Obesity On The Hypercoagulable State Of Polycystic Ovary Syndrome: A Risk For Severe SARS-Cov-2 Infection?

Rasprostranennost' narusheniy svertyvayushchey i protivosvertyvayushchey sistem krovi u zhenshchin s metabolicheskim sindromom v postmenopauze

Metabolic syndrome as a prothrombogenic state

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