Increased Coagulation and Decreased Fibrinolysis as Measured with Overall Hemostatic Potential Are Dependent on BMI and Not Associated with PCOS

Rakuša, Matej; Jensterle, Mojca; Mijovski, Mojca Božič

doi:10.1089/met.2016.0148

“…Global haemostatic assays for net yields of coagulation and fibrinolysis have recently been proposed as more suitable indicators for overall haemostasis appraisal [ 19 ]. They have been extensively validated in diverse populations, including patients with CAD [ 20 , 24 , 25 , 34 ]. In our study, OCP levels—indicating hypercoagulability—were comparable to other studies of patients with CAD [ 23 , 25 ] and significantly increased in patients with an elevated TyG index.…”

Section: Discussionmentioning

confidence: 99%

“…Since coagulation is a complex and multifactorial process, global haemostatic essays-as opposed to the measurement of individual procoagulant and fibrinolytic factors-have recently gained popularity [19]. Overall haemostatic potential (OHP) is a global haemostasis essay [20,21], which has been validated in healthy individual as well as various groups of patients [22][23][24]. In CAD patients, OHP detected a hypercoagulability state, driven primarily by impaired fibrinolysis [23,25].…”

Section: Introductionmentioning

confidence: 99%

The Correlation between the Triglyceride-Glucose Index and Coagulation Markers in Patients with Recent Acute Myocardial Infarction

Košuta

¹

,

Novaković

²

,

Mijovski

³

et al. 2022

Disease Markers

0

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Background. Metabolic abnormalities and hypercoagulability seem to have an important predictive role in patients with coronary artery disease (CAD). The triglyceride-glucose (TyG) index has emerged as a good marker for metabolic syndrome with predictive value for cardiovascular events. Overall haemostatic potential (OHP) is a reliable global haemostatic essay to identify hypercoagulability in CAD patients. The aim of our study was therefore to evaluate a possible correlation between the TyG index and haemostatic derangements in patients with CAD. Methods. Consecutive patients referred for the first follow-up visit after acute myocardial infarction between December 1, 2018, and March 31, 2020, and did not meet exclusion criteria were included. We determined OHP, overall coagulation potential (OCP), overall fibrinolytic potential (OFP), fibrinogen, D-dimer, and von Willebrand factor from peripheral blood samples. The TyG index was calculated with the previously described and validated formula. Linear regression models were constructed for the multivariate analysis. Results. A total of 117 patients (mean age 56 ± 10 years, 20% women) were included. A correlation was found between TyG index and OCP ( r = 0.229 , p = 0.026 ), TyG index and OHP ( r = 0.202 , p = 0.050 ), and TyG index and fibrinogen ( r = 0.271 , p = 0.005 ). In the multivariate model which accounted for sex, age, and BMI, the correlation between TyG index and OCP ( R 2 0.108; ANOVA for regression p = 0.035 ; beta 2.08 [0.79-4.01], p = 0.042 ) and between TyG index and fibrinogen ( R 2 0.11; ANOVA for regression p = 0.015 ; beta 0.35 [0.08-0.62], p = 0.012 ) emerged as statistically significant. Conclusion. The TyG index, a marker of metabolic syndrome, has a strong correlation with a hypercoagulability state in CAD, as determined by the OCP and higher fibrinogen levels. Our findings suggest that metabolic syndrome may be an important driver of atherothrombotic risk in patients with CAD.

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“…For example, bronectin is correlated to BMI (17) and obesity is associated with increased PAI-1 in PCOS (18). 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).…”

Section: Discussionmentioning

confidence: 99%

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

Moin¹,

Sathyapalan²,

Diboun³

et al. 2020

Preprint

0

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Introduction: Polycystic ovary syndrome (PCOS) women have a hypercoagulable state and are also at high risk for severe COVID-19 leading to thromboembolic complications and increased mortality; however, whether this is intrinsically due to PCOS or, alternatively, a consequence of its metabolic complications is unclear. Methods: We determined plasma coagulation pathway protein levels in PCOS (n=146) and control (n=97) women recruited to a PCOS biobank. Circulating levels of a panel of 18 clotting pathway proteins were determined by Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement.Results: Cohorts were age matched, though PCOS had elevated body mass index (BMI)(p<0.001), insulin (p<0.001) and C-reactive protein (CRP)(p<0.0001). Eight pro-coagulation proteins were elevated in PCOS: plasminogen activator inhibitor-1 (PAI-1)(p<0.0001), fibrinogen (p<0.01), fibrinogen gamma chain (p<0.0001), fibronectin (p<0.01), von Willebrand factor (p<0.05), D-dimer (p<0.0001), P-selectin (p<0.05), and plasma kallikrein (p<0.001). However, two anticoagulant proteins, vitamin K-dependent protein-S (p<0.0001) and heparin cofactor-II (p<0.001) were elevated and prothrombin was decreased (p<0.05). CRP, as a marker of inflammation, and insulin resistance (HOMA-IR) correlated with 11 and 6 of the clotting proteins, respectively (p<0.05). When matched for BMI<25 (16 PCOS, 53 controls) HOMA-IR remained elevated (p<0.05) and heparin cofactor-II was increased (p<0.05). In a multivariate analysis accounting for inflammation, insulin resistance and BMI, there was no correlation of PCOS with any of the coagulation proteins.Conclusion: The hypercoagulable State in PCOS can be fully accounted for by BMI, inflammation and insulin resistance suggesting that only obese PCOS women would be predisposed to an enhanced risk for severe COVID-19-related disease.

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“…Increased fat mass-associated elevation of circulating PAI-1 can inhibit plasmin-mediated fibrinolysis. Overall coagulation potential and decreased fibrinolysis (as reflected in overall homeostatic potential) have been demonstrated to increase with increase in BMI [ 379 ]. Platelet activation in obesity was indicated by higher excretion of 11-dehydroTBX2, a metabolite of thromboxane and a marker of platelet activation, by obese subjects and its reduction to normal levels on weight loss [ 380 ].…”

Section: Why Is Obesity a Risk For Covid-19 ?—Pathways And Molecular ...mentioning

confidence: 99%

Mechanisms contributing to adverse outcomes of COVID-19 in obesity

Sudhakar

¹

,

Winfred

²

,

Gowri

³

et al. 2022

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A growing amount of epidemiological data from multiple countries indicate an increased prevalence of obesity, more importantly central obesity, among hospitalized subjects with COVID-19. This suggests that obesity is a major factor contributing to adverse outcome of the disease. As it is a metabolic disorder with dysregulated immune and endocrine function, it is logical that dysfunctional metabolism contributes to the mechanisms behind obesity being a risk factor for adverse outcome in COVID-19. Emerging data suggest that in obese subjects, (a) the molecular mechanisms of viral entry and spread mediated through ACE2 receptor, a multifunctional host cell protein which links to cellular homeostasis mechanisms, are affected. This includes perturbation of the physiological renin-angiotensin system pathway causing pro-inflammatory and pro-thrombotic challenges (b) existent metabolic overload and ER stress-induced UPR pathway make obese subjects vulnerable to severe COVID-19, (c) host cell response is altered involving reprogramming of metabolism and epigenetic mechanisms involving microRNAs in line with changes in obesity, and (d) adiposopathy with altered endocrine, adipokine, and cytokine profile contributes to altered immune cell metabolism, systemic inflammation, and vascular endothelial dysfunction, exacerbating COVID-19 pathology. In this review, we have examined the available literature on the underlying mechanisms contributing to obesity being a risk for adverse outcome in COVID-19.

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Increased Coagulation and Decreased Fibrinolysis as Measured with Overall Hemostatic Potential Are Dependent on BMI and Not Associated with PCOS

Abstract: PCOS was not associated with increased OHP compared with BMI and age-matched controls. However, increase in OHP was positively associated with BMI in PCOS and healthy women.

Cited by 7 publications

References 25 publications

The Correlation between the Triglyceride-Glucose Index and Coagulation Markers in Patients with Recent Acute Myocardial Infarction

The Correlation between the Triglyceride-Glucose Index and Coagulation Markers in Patients with Recent Acute Myocardial Infarction

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

Mechanisms contributing to adverse outcomes of COVID-19 in obesity

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