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Inflammatory and prothrombotic parameters in normotensive non-diabetic obese women: effect of weight loss obtained by gastric banding

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Abstract

Hypertension and diabetes are known risk factors for obesity-related thrombosis, but several studies have shown that obesity is characterised by a potentially prothrombotic inflammatory state because of activated coagulation and impaired fibrinolysis. In order to verify if obese patients—unaffected by hypertension, diabetes, dyslipidemia, cigarette smoking or inflammatory diseases—show increased prothrombotic markers and whether the weight loss induced by gastric banding normalises such parameters. Plasma levels of C reactive protein (CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (VWF) and factor VII (FVII) were measured in 25 women with isolated obesity prior to, as well as 3, 6 and 12 months subsequent to gastric banding. Twenty-five healthy women served as a baseline control group. The obese women had higher CRP (p = 0.0001), fibrinogen (p = 0.014), PAI-1 (p = 0.003), VWF (p = 0.004) and FVII levels (p = 0.0001) than the normal controls, and their body mass index (BMI) positively correlated with CRP (r = 0.462, p = 0.02), fibrinogen (r = 0.426, p = 0.04) and PAI-1 (r = 0.468, p = 0.02). Twelve months after gastric banding, the median BMI had decreased from 40.0 to 34.9 (p = 0.0001); CRP from 4.18 to 1.69 μg/ml (p = 0.01); fibrinogen from 389 to 318 mg/dl (p = 0.0001); PAI-1 from 32.1 to 12.0 UI/ml (p = 0.003); VWF from 144 to 120% (p = 0.0001); and FVII from 134 to 112% (p = 0.002). Even in the absence of major cardiovascular risk factors, obese patients are characterised by a prothrombotic state. The weight loss induced by gastric banding decreases the parameters of inflammation, coagulation and impaired fibrinolysis, thus potentially reducing the thrombotic risk.

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Acknowledgments

This study was supported by “FondoInterno per la RicercaScientifica e Tecnologica” University of Milan.

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Authors and Affiliations

  1. Department of Internal Medicine, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Via Pace 9, 20122, Milan, Italy

    Massimo Cugno, Roberto Castelli, Massimo Boscolo-Anzoletti & Pier Mannuccio Mannucci

  2. Geriatric Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Daniela Mari

  3. Department of Surgical Sciences, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Enrico Mozzi, Marco Antonio Zappa & Giancarlo Roviaro

  4. Scientific Direction, IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Pier Mannuccio Mannucci

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  1. Massimo Cugno
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  3. Daniela Mari
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Correspondence to Massimo Cugno.

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Cugno, M., Castelli, R., Mari, D. et al. Inflammatory and prothrombotic parameters in normotensive non-diabetic obese women: effect of weight loss obtained by gastric banding. Intern Emerg Med 7, 237–242 (2012). https://doi.org/10.1007/s11739-011-0522-x

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