Increase in both pro-thrombotic and anti-thrombotic factors in obese premenopausal women: relationship with body fat distribution

Abstract

OBJECTIVE: To examine the relationship of obesity, body fat distribution, and fasting plasma insulin concentrations with the plasma levels of both pro-thrombotic and anti-thrombotic factors in premenopausal women. SUBJECTS: 32 obese women with BMI b 28 and 33 age-matched non-obese women with BMI`25. MEASUREMENTS: (i) plasma concentrations of plasminogen activator inhibitor-1 antigen (PAI-1 Ag), plasminogen activator inhibitor-1 activity (PAI-1 activity), ®brinogen, von Willebrand factor antigen (vWF Ag), von Willebrand factor activity (vWF activity), and factor VII activity as pro-thrombotic factors; (ii) plasma concentrations of tissue plasminogen activator antigen (t-PA Ag), protein C, and antithrombin III as anti-thrombotic factors; (iii) fasting plasma insulin and glucose concentrations, and the lipid pattern (triglycerides, total and HDL-cholesterol) as metabolic parameters. The body fat distribution was evaluated by measuring the waist circumference and the waist-to-hip ratio (WHR). RESULTS: Obese subjects had higher plasma concentrations of all pro-thrombotic factors as compared to non-obese controls (PAI-1 Ag, P`0.001; PAI-1 activity, P`0.05; ®brinogen, P`0.001; vWF Ag, P`0.001; vWF activity, P`0.05; factor VII, P`0.05). The plasma concentrations of PAI-1 Ag and vWF Ag were directly correlated with the waist circumference independently of other metabolic and non-metabolic variables (P`0.05). Obese women were also characterized by higher plasma concentrations of anti-thrombotic factors such as t-PA Ag and protein C as compared to non-obese controls (P`0.001 and P`0.001, respectively), although these factors were not independently correlated with the waist circumference or the WHR. CONCLUSION: Plasma concentrations of the pro-thrombotic factors are increased in obese women as compared to non-obese controls, and plasma levels of PAI-1 Ag and vWF Ag correlate with central fat accumulation speci®cally. Plasma concentrations of anti-thrombotic factors (namely protein C and t-PA Ag) are also raised in obese women, but they are not correlated with parameters of body fat distribution. The increase in protein C levels may represent a protective response partly counteracting the increase in pro-thrombotic factors in these individuals.

Social Determinants of von Willebrand Factor

“…Thus, an association with postload glucose was observed in both sexes. In accordance with previous reports, an association between waist-hip ratio 11,21 and triglycerides 11 was observed in women. No significant associations were observed with triglycerides and systolic blood pressure.…”

Effects of an antiandrogenic oral contraceptive pill compared with metformin on blood coagulation tests and endothelial function in women with the polycystic ovary syndrome: influence of obesity and smoking

“…In this regard, abdominal adiposity is not only an intrinsic characteristic of PCOS patients (10) but also very common in smokers in studies conducted in the general population (28)(29)(30). The fact that the effect of smoking on the blood coagulation abnormalities found in our series of young women was no longer statistically significant when correcting for the influence of abdominal adiposity strongly suggests that the synergistic effect of PCOS and smoking on abdominal adiposity may worsen the prothrombotic profile of these women (31,32).…”

Involvement of leptin in the association between percentage of body fat and cardiovascular risk factors

“…The pronounced increase in vWF observed in obese patients confirms that obesity has an adverse effect on the endothelium [27,28]. However, vWF did not show a significant correlation with either BF or leptin.…”