Effect of a 3-Week Low-Calorie Diet and Balneological Treatment on Selected Coagulation Parameters in Morbidly Obese Patients

Abstract

is greater than energy expenditure, causing both the hyperplasia and the hypertrophy of adipocytes. Adipocyte hypertrophy has negative consequences connected with insulin resistance and chronAccording to the World Health Organization (WHO), obesity is related to an excessive accumulation of adipose tissue, which may result in health deterioration [1]. This occurs when energy input AbstractBackground. The most common cause of death among people with obesity are cardiovascular complications as a result of a hypercoagulability state. Objectives. The purpose of the study was to assess the potential of coagulation system activation depending on the tissue factor and to analyze of the influence of a 3-week low-calorie diet and balneological treatment on selected coagulation parameters in morbidly obese patients. Material and Methods. The study included 36 patients (28 females and 8 males; mean age 46) with the value of BMI > 40 kg/m 2 . The study was designed in two stages: baseline and after 21-days. The evaluation of tissue factor (TF), tissue factor pathway inhibitor (TFPI), von Willebrand factor (vWF), fibrinogen, D-dimer, thrombin--antithrombin complexes (TAT), and the activity of antithrombin (AT) was performed in patients before and after the treatment. The control group consisted of 24 healthy volunteers (16 females and 8 males) at a mean age of 39 with BMI ≤ 24.9 kg/m 2 . Results. There were significantly higher levels of TF, TFPI, fibrinogen, TAT complexes and D-dimer in the study group as compared to the controls. Moreover, there were no significant changes in the parameters studied before and after the treatment. In the group of obese patients, there were significant positive correlations between the concentrations of vWF and BMI and BMI changes and a significant negative correlation between the WHR changes and TFPI concentration. Conclusions. The study confirmed that morbidly obese patients represent a high risk of hypercoagulability state, despite no clinical evidence, which could be due to the great inhibitory potential of TFPI in suppressing the extrinsic pathway of the coagulation system. However, the lack of effect of the 3-week exposure to the LCD and balneological treatment in morbidly obese subjects indicates that substantial fat mass must be reduced before adequate hemostasis is re-established (Adv Clin Exp Med 2016, 25, 4, 755-761).

Effects of Obesity Surgery on Blood Coagulation and Fibrinolysis: A Literature Review

“…38,40,41 In line with this, several studies have compared a number of hemostatic biomarkers in people with obesity and normal weight. These studies conclude that obesity is accompanied by increased levels of biomarkers of endothelial function, e.g., t-PA:Ag and von Willebrand factor (vWF), [42][43][44][45][46] coagulation, e.g., fibrinogen, FVII, TF, factor IX (FIX), factor X (FX), factor XII (FXII), F1 þ 2, thrombin-AT complexes (TAT), Ddimer, 34,42,44,45,[47][48][49][50][51][52] and impaired fibrinolysis, for example, PAI-1 42,43,45,46,51,53 and TAFI. 54,55 Interestingly, it has been suggested that obesity is accompanied by elevated concentrations of coagulation inhibitors, such as protein C, AT, and TFPI, 38,52,56 perhaps as a protective response toward the increased thrombotic risk in obesity.…”

The effect of balneotherapy on body mass index, adipokine levels, sleep disturbances, and quality of life of women with morbid obesity

“…Others, such as cancer, ischemic heart disease with myocardial infarction, or cerebral stroke, pose a serious threat to life. The last two complications are major causes of death of subjects with morbid obesity (Firszt-Adamczyk et al 2016; World Health Organization Obesity Technical report series No: 894 Obesity: Preventing and managing the global epidemic. 2000).…”

“…There are many methods used such as diet treatments, exercise treatments, drug treatments, and surgical interventions (Ricci et al 2016). These treatments include balneotherapy (Fioravanti et al 2015a;Firszt-Adamczyk et al 2016;Hanh et al 2012;Jokic et al 2018;Matsumoto 2018;Olah et al 2011;Rapolienė 2016;Rosc et al 2015), which traditionally involves immersion in mineral and/or thermal waters from natural springs, but may interchangeably be defined as balneological interventions with natural gases (CO 2 , sulfur and radon, etc. ), peloids (mud) and other traditional remedies (for example, hay), whereas hydrotherapy generally employs normal tap water for medical treatment (Fioravanti et al 2017).…”

Characterization of the blood coagulation system in morbidly obese patients

“…On the other hand, in obese individuals, fibrinolysis is inhibited. A direct relationship has been established between morbid obesity and an increased level of tissue factor, blood coagulation factors VII and VIII, von Willebrand factor, antithrombin III, TAT complex and fibrinogen and, indirectly, endothelial damage as an independent factor contributing to the risk of thrombosis [24][25][26][27][28][29].…”