Weight Loss Reduces Tissue Factor in Morbidly Obese Patients

Abstract

2 ), undergoing elective gastroplasty for the induction of weight loss, were examined for hemostatic, metabolic, and inflammatory parameters at baseline and 14 Ϯ 5 months postoperatively. Results: Weight loss significantly reduced circulating plasma TF (314 Ϯ 181 vs. 235 Ϯ 113 pg/mL, p ϭ 0.04), coagulation factor VII (130 Ϯ 22% vs. 113 Ϯ 19%, p ϭ 0.023), and prothrombin fragment F1.2 (2.4 Ϯ 3.4 vs. 1.14 Ϯ 1.1 nM, p ϭ 0.04) and normalized glucose metabolism in 50% of obese patients preoperatively classified as diabetic or of impaired glucose tolerance. The postoperative decrease in plasma TF correlated with the decrease of F1.2 (r ϭ 0.56; p ϭ 0.005), a marker of in vivo thrombin formation. In subgroup analysis stratified by preoperative glucose tolerance, baseline circulating TF (402.6 Ϯ 141.6 vs. 176.2 Ϯ 58.2, p Ͻ 0.001) and TF decrease after gastroplasty (⌬TF: 164.7 Ϯ 51.4 vs. Ϫ81 Ϯ 31 pg/mL, p ϭ 0.02) were significantly higher in obese patients with impaired glucose tolerance than in patients with normal glucose tolerance. Discussion: Procoagulant TF is significantly reduced with weight loss and may contribute to a reduction in cardiovascular risk associated with obesity.

Effect of diet-induced energy deficit and body fat reduction on high-sensitive CRP and other inflammatory markers in obese subjects

“…10,11,[14][15][16][17]19,28,29,42 The present concentration of glucose, insulin and HOMA decreased after weight losses but tended to rise towards baseline level in the subsequent weight maintenance periods. No relationship was observed between the changes in hs-CRP and the glycemic markers, whereas the change in IL-6 related to insulin and HOMA after the first weight loss but not the second.…”

“…38,39,[52][53][54][55] The adipokines adiponectin and leptin have previously been connected with pro-inflammatory markers. A reduction in FM has been shown to induce a decline in leptin concentration 28,35,40,41 and a rise in adiponectin concentration. 14,15,29,40 However, the present study failed to provide the expected increase in adiponectin as a response to the fat loss possibly due to the study being simply underpowered.…”

“…16,28,29,35,36 However, only hs-CRP and IL-6 were Figure 2 Loading plot of factor structure of the pro-inflammatory markers high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), fibrinogen, haptoglobin, transferrin and the adipokines leptin and adiponectin. Factor 1 was related to fibrinogen (0.81), CRP (0.63), haptoglobin (0.71), IL-6 (0.64) whereas adiponectin, leptin and transferrin were not.…”

“…The chosen markers have all previously been observed to be affected by obesity and/or weight loss, but have been investigated in a very different manner. 9,10,[25][26][27][28][29][30] Therefore, we also compared the changes in the well-investigated markers, hs-CRP and IL-6, with the mentioned acute phase reactants as an effect of weight loss regimens and maintenance. Furthermore, we attempted to compare hs-CRP and IL-6 with more traditional risk markers of the insulin resistance syndrome (IRS) and CVD.…”

Hemostatic abnormalities in endocrine and metabolic disorders

“…intercellular adhesion molecule-1, P-selectin, and E-selectin) than those without the syndrome (142)(143)(144)(145). Moreover, increased endothelial cell microparticles (EMP) release, platelet and leukocyte hyperactivation, increased binding of both EMPs and platelets to leukocytes are also shown in patients with the metabolic syndrome (133,146).…”