Fibrin lysability is associated with central obesity and inflammation in women with polycystic ovary syndrome

Abstract

IntroductionPolycystic ovary syndrome (PCOS) is characterized by increased central fat mass (CFM), hyper‐inflammation, and hemostatic alterations; the risk of cardiovascular disease may also be increased. Reduced fibrin lysability is a risk factor for cardiovascular disease. The present study assessed fibrin lysability in women with PCOS and controls of similar age and body mass index.Material and methodsNinety women with PCOS and 35 controls of comparable age and body mass index were included. Hemostatic markers (fibrin lysability, fibrinogen, coagulation factor XIII, plasminogen, plasminogen activator inhibitor 1 [PAI‐1], plasmin inhibitor, thrombin activatable fibrinolysis inhibitor (TAFI), D‐dimer), C‐reactive protein (CRP), body mass index, waist‐to‐hip ratio, CFM determined by Dual‐energy X‐ray absorptiometry scan, and sex hormones (testosterone estradiol, and sex hormone binding globulin) were determined.ResultsTAFI and CRP were higher in women with PCOS, than controls. In women with PCOS, fibrin lysability correlated with CFM, waist‐to‐hip ratio, CRP, fibrinogen, and all hemostatic variables (P ≤ .004) except TAFI and D‐dimer. CFM correlated with fibrinogen, CRP, coagulation factor XIII, waist‐to‐hip ratio, plasminogen, PAI‐1, plasmin inhibitor, and TAFI (P < .02). In controls, fibrin lysability correlated with CFM, fibrinogen, coagulation factor XIII, and plasmin inhibitor (P ≤ .02). CFM correlated with PAI‐1, plasmin inhibitor, coagulation factor XIII, fibrinogen, and CRP (P ≤ .05). Stepwise regression analysis revealed that fibrin lysability was associated with CFM, fibrinogen and CRP in women with PCOS (r2 = .46, P ≤ .001), but only with CFM in controls (r2 = .28, P < .001).ConclusionsFibrin lysability was comparable in women with PCOS and controls. Fibrin lysability was associated with CFM and hyper‐inflammation in women with PCOS, but only with CFM in controls. These findings suggest that obese women with PCOS and augmented inflammation could have an increased risk of cardiovascular disease.

The Role of Chronic Inflammation in Polycystic Ovarian Syndrome—A Systematic Review and Meta-Analysis

“…Of these, 45 studies provided data on other inflammatory markers such as IL-6, TNF-α, adiponectin, etc., as summarised in Table 2. Mean ± SD CRP values were not provided in 22 studies [42,46,60,62,63,65,66,68,72,73,78,82,83,92,93,99,108,110,112,118,119,121]. Authors of these articles were contacted to provide the missing data, but no response was received despite several reminders.…”

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

“…In ammation crosstalk with coagulation leading to increased coagulopathy is well recognized; however, with the initiation of coagulation, the coagulation proteases may then modulate the in ammatory response (21,22). In PCOS, both CRP and brinogen are predicted by BMI in accord with obesity initiating the increased in ammation (23) and particularly CRP, PAI-1, D-dimer, Antithrombin III with central fat mass as noted above (20).…”

“…Others have reported, using a repeated brin formation and degradation functional assay, that "overall hemostatic potential" was BMI-dependent and not associated with PCOS (19). Central fat mass has been associated with brinogen, CRP, coagulation factor XIII, waist-to-hip ratio, plasminogen, PAI-1, plasmin inhibitor, and thrombin activatable brinolysis inhibitor (20) Conversely, thrombin-activatable brinolysis inhibitor, PAI-1, D-dimer, Antithrombin III and thrombomodulin were reported to be signi cantly increased in women with PCOS compared with age-and BMI-matched controls, suggesting that alterations in these proteins are BMI-independent and due to other factors such as in ammation and insulin resistance, as reported here (4).…”

Fibrinolytic Changes in Women with Preeclampsia

“…Thrombin activatable fibrinolysis inhibitor (TAFI) was determined with the VisuLize TAFI antigen kit from Affinity Biologicals, Ontario, Canada. 18 …”

“…Thrombin activatable fibrinolysis inhibitor (TAFI) was determined with the VisuLize TAFI antigen kit from Affinity Biologicals, Ontario, Canada. 18 The protein concentration of PAI-2 was assessed by an in-house prepared ELISA employing specific monoclonal antibody (mAb) as capture and polyclonal antibody (pAb) as detection. Briefly, MaxiSorp plates (NuncTM MaxisorpTM, Roskilde Denmark) were coated with 2.5 µg/mL mAb clone 19-26-3 against PAI-2 in coating buffer overnight at 4 °C.…”