Coagulation, fibrinolysis and haemorheology in premenopausal obese women with different body fat distribution

Avellone, G; Garbo, Vincenzo Di; Cordova, Rosamaria; G, Raneli; Simone, R. De; Bompiani, G

doi:10.1016/0049-3848(94)90233-x

Cited by 39 publications

(26 citation statements)

References 30 publications

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“…Although modest weight loss does not affect fibrinogen concentration, usually elevated in obese subjects, 34,35 the massive weight reduction obtained with biliary-intestinal bypass induces a significant reduction of plasma fibrinogen levels at and beyond the end of the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…7 Alone, each component of the cluster conveys an increased risk of CVD, but as a combination they become much more powerful and severe. 8 Obese patients show an increased prevalence of hypertension, 9 dyslipidaemia, hyperglycaemia and fibrinogen excess, 10 in addition to CVDs such as coronary heart disease and stroke. [11][12][13] Life style modification should be the goal of obesity treatment.…”

Section: Introductionmentioning

confidence: 99%

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Reduction of risk factors for cardiovascular diseases in morbid-obese patients following biliary-intestinal bypass: 3 years' follow-up

et al. 2004

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BACKGROUND: Obese patients are often affected by hypertension, dyslipidaemia, impaired glucose metabolism, and suffer from cardiovascular disease (CVD), related to the characteristic metabolic alterations. AIM OF THE STUDY: To evaluate reduction of risk factors for CVDs in morbid-obese patients (body mass index (BMI)440 kg/m 2 ) after weight loss upon bariatric surgery intervention of biliary-intestinal bypass. SUBJECTS: 45 (17 men, 28 women) morbid-obese patients (age: 19-49 y, BMI440 kg/m 2 ). All patients were selected on the basis of medical history, physical and biochemical evaluation and of psychiatric tests, which were performed on all individuals admitted to our Day Hospital to verify the safety of surgical intervention. MEASUREMENTS: Body weight, body composition (by dual X-ray absorptiometry, DXA), blood pressure, lipid profile, fibrinogen and glucose metabolism were monitored at baseline and 1, 3, 6, 9, 12, 24 and 36 months after surgery. RESULTS: A significant and persistent weight loss was present in all patients at the end of the 3 y follow-up period (Po0.001), with a progressive reduction of total and trunk fat mass as evaluated by means of DXA. Additionally, a parallel significant reduction in systolic (Po0.001) and diastolic (Po0.001) blood pressure was observed. Total and LDL cholesterol were significantly reduced (Po0.001), while HDL showed no modifications; triglycerides declined progressively during the 3 y followup (Po0.001). Fibrinogen decreased from 364.5782.4 to 266.4745.7 mg/dl at the end of the period (Po0.001). Fasting glucose levels and glucose levels 120 min after an oral glucose tolerance test were reduced from 95.1720.3 to 78.679.1 mg/dl (Po0.001) and from 116.9734.7 to 77.6715.5 mg/dl (Po0.001), respectively, at baseline and at the end of the study. Moreover, fasting insulin decreased from 30.0720.4 to 8.672.9 mUI/ml (Po0.001) after 3 y, while insulin levels after (120 min) oral glucose load decreased from 105.5761.5 to 12.076.0 mUI/ml (Po0.001). CONCLUSION: Our results show that biliary-intestinal bypass may represent a valid and alternative therapeutic approach in patients with morbid obesity since it induces a significant and stable reduction of body weight and obesity-related risk factors for CVD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reduction of risk factors for cardiovascular diseases in morbid-obese patients following biliary-intestinal bypass: 3 years' follow-up

et al. 2004

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“…When other ethnic subgroups have been considered, the pivotal role of central obesity, as compared with general obesity, is less persuasive. 30,62 ± 64 Obesity, regardless of its distribution, is acknowledged to be related to insulin resistance syndrome-associated dyslipidemia, hyperinsulinemia, diabetes, hypertension and ®brinogen excess 65,66 and to be inversely related to smoking. 67 Among nondiabetic populations, our data support the associations of obesity with other risk factors, including HDL, insulin, HbA 1c , blood pressure and LDL size.…”

Section: Discussionmentioning

confidence: 99%

Relation of generalized and central obesity to cardiovascular risk factors and prevalent coronary heart disease in a sample of American Indians: the Strong Heart Study

et al. 2000

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and 4 Aberdeen Tribal Chairmen's Health Board, Rapid City, SD, USA OBJECTIVE: To examine the hypothesis linking measures of obesity including body mass index (BMI), waist circumference (waist) and percentage body fat to coronary heart disease (CHD) prevalence and its risk factors in American Indians. DESIGN: The Strong Heart Study assesses the prevalence of CHD and its risk factors in American Indians in Arizona, Oklahoma and SouthaNorth Dakota. Participants underwent a physical examination and an electrocardiogram; anthropometric and blood pressure measurements were taken, as were measurements of glucose, lipoproteins, ®brinogen, insulin, hemoglobin A 1c and urinary albumin. PARTICIPANTS: Data were available for 4549 men and women between 45 and 74 y of age. MEASUREMENTS: Obesity, measured using body mass index, waist circumference and percentage body fat, was correlated with prevalent CHD and its risk factors. RESULTS: More than 75% of participants were overweight (BMI b 25 kgam 2 ). Measures of obesity were greater in women than in men, in younger than in older participants, and in participants with diabetes than in nondiabetic participants. CHD risk factors were associated with measures of obesity but, except for insulin concentration, changes in metabolic variables with increasing obesity were small. Associations were not stronger with waist than with BMI. The prevalence of CHD in those whose BMI andaor waist measurements lay in the lowest and highest quintiles, by gender and diabetic status, was similar. CONCLUSIONS: Although CHD risk factors are associated with obesity in American Indians, distribution of obesity (ie waist) is no more closely related to risk factors than is generalized obesity (ie BMI), and changes in CHD risk factors with obesity were small. Thus, the relations among obesity, body fat distribution and CHD risk may differ in this population.

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“…Specifically, obesity-related arterial hypertension 5 as well as elevated viscosity of the blood 24 have been shown to stimulate the growth of cardiac walls and, subsequently, induce concentric left ventricular hypertrophy (LVH). 25 In the absence of hypertension, the heart may also be damaged under these circumstances by chronic volumeoverload due to an elevated cardiac output. 25 …”

Section: Left Ventricular Hypertrophymentioning

confidence: 99%

Obesity and target organ damage: the heart

Schunkert

2002

Int J Obes

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In most patients, coronary atherosclerosis or congestive heart failure develop as an integrated response to multiple cardiovascular risk factors. Obesity increases the prevalence of most cardiovascular risk factors and is the predominant cause of diabetes mellitus and arterial hypertension. Moreover, obesity shifts the manifestation of these risk factors to younger age groups, such that subsequent damage results prematurely in clinically overt cardiac diseases. In addition, due to clustering of obesity-related risk factors, obesity may amplify the risk by synergistic mechanisms acting in parallel. Finally, an elevated body mass index (BMI) results in an increase in heart rate and blood volume, as well as increased systolic and diastolic blood pressure. These changes affect cardiac geometry and mass in addition to the alterations of the coronary vasculature. At the population level, the role of obesity in promoting multiple risk factors and, subsequently, the development of heart diseases cannot be underestimated. In individual patients, however, the clinical presentation may be dominated by obesity-related hypertension, diabetes, metabolic and inflammatory derangements or clinical symptoms of heart failure or coronary artery disease. Weight reduction remains a crucial component of the therapeutic strategy to ameliorate insulin resistance, hypertension and left ventricular hypertrophy, among other risk factors, with profound implications for the individual's prognosis.

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Coagulation, fibrinolysis and haemorheology in premenopausal obese women with different body fat distribution

Cited by 39 publications

References 30 publications

Reduction of risk factors for cardiovascular diseases in morbid-obese patients following biliary-intestinal bypass: 3 years' follow-up

Reduction of risk factors for cardiovascular diseases in morbid-obese patients following biliary-intestinal bypass: 3 years' follow-up

Relation of generalized and central obesity to cardiovascular risk factors and prevalent coronary heart disease in a sample of American Indians: the Strong Heart Study

Obesity and target organ damage: the heart

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