Thrombin generation in severely obese children

Cimenti, Christina; Mangge, Harald; Haidl, Harald; Zach, D.; Muntean, W.

doi:10.1111/j.1538-7836.2006.02038.x

Cited by 31 publications

(11 citation statements)

References 18 publications

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“…Cimenti et al [26] described significantly higher thrombin generation levels in severely obese children, when compared with age-matched, normal-weight, healthy controls. Up to now, data on thrombin generation in adult obese patients and the effects of weight loss on thrombin generation have not been available.…”

Section: Discussionmentioning

confidence: 99%

Thrombin generation in morbid obesity: significant reduction after weight loss

Kopp

Brix

et al. 2010

Journal of Thrombosis and Haemostasis

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) suffer from an increased risk of cardiovascular disease, stroke, venous thromboembolism and all-cause mortality. Objectives: Because weight loss by bariatric surgery reduces cardiovascular and all-cause mortality, we hypothesized that the plasmatic clotting system might be involved in cardiovascular risk. Patients/Methods: Thirty-six MO patients [mean age 42 (±13) years; 29 female) were investigated before and 2 years after bariatric surgery. Thrombin generation was measured with a commercially available assay (Technothrombin-TGA,Technoclone). Metabolic parameters and parameters of the hemostatic system, such as tissue factor (TF), TF pathway inhibitor (TFPI), plasminogen activator inhibitor-1 (PAI-1) and prothrombinfragment 1.2 (F1.2), were determined. To investigate associations of changing parameters, deltas were calculated. Results: Metabolic parameters improved with a mean weight loss of 41 (±19) kg. Postoperatively, the lag phase was significantly extended compared with preoperative values [median (25th-75th percentile), 7 (4-12) vs. 12 (7-19) min, P = 0.005]. Peak thrombin decreased after weight loss from 345 (232-455) to 282 (111-388) nM (P = 0.015) and the area under the curve from 3962 (3432-5023) to 3227 (2202-4030) nM thrombin (P < 0.001). TF, PAI-1 and F1.2 significantly decreased after weight loss. Analyses of the deltas showed a significant correlation between peak thrombin and total cholesterol (r = 0.50), triglycerides (r = 0.46) and HbA1c (r = 0.55). Moreover, an inverse correlation was found between insulin resistance and the lag phase (r = )0.46). Conclusion: Thrombin generation, a marker of the overall coagulation potential, decreased significantly with weight reduction. This might, at least in part, explain the decreased risk of cardiovascular disease after bariatric surgery.

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Section: Discussionmentioning

confidence: 99%

Thrombin generation in morbid obesity: significant reduction after weight loss

Kopp

Brix

et al. 2010

Journal of Thrombosis and Haemostasis

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“…Such parameters were not correlated with ETP. Elevated ETP was found in obese or overweight compared with lean children, 13,14 and a reduction in ETP has been described 2 years after bariatric surgery. 12 However, the above-mentioned studies were performed in morbidly obese patients, and a possible role of nutritional factors has not been taken into account.…”

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confidence: 99%

“…Elevated ETP is associated with excessive body weight 12,13 and with characteristics of metabolic syndrome (metS). 14 MetS associates central obesity, high blood pressure, insulin resistance, high glucose levels, and dyslipidemia.…”

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confidence: 99%

Diet Modulates Endogenous Thrombin Generation, A Biological Estimate of Thrombosis Risk, Independently of the Metabolic Status

Sánchez

Poggi

Morange

et al. 2012

ATVB

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Objective— High endogenous thrombin potential (ETP) is associated with venous and arterial thrombosis. Better knowledge of environmental influences on ETP may help to prevent thrombosis. Methods and Results— Weaning rats exhibited high ETP values that decreased in low-fat diet and remained elevated on high-fat diet. In adult rats, high-fat diet–induced ETP increase was independent of coagulation factors, obesity, and insulin resistance and negatively associated with polyunsaturated fatty acid levels. Switching from high-fat diet to low-fat diet reversed the procoagulant phenotype with a slower kinetic than the normalization of hyperinsulinemia. In humans, ETP was independent of body weight whereas it was negatively associated with nutritional markers such as the percentage of energy provided by proteins, the protein:fat ratio, circulating phenolic compounds, and omega-3 polyunsaturated fatty acid. A recommended 3-month healthy diet with reduced energy density, including lipids, decreased ETP (−21%; P <0.0001). Changes in ETP were not associated with body weight, insulin sensitivity, or coagulation factor variations, but correlated negatively with plasma docosahexaenoic acid, a nutritional status sensitive fatty acid, and compounds reflecting vegetable intake. Conclusion— Diet plays a pivotal role in regulating ETP, independently of obesity and insulin resistance. Global nutritional recommendations could be useful in primary prevention of venous thrombosis.

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“…9 -12 Evidence so far linking obesity to an individual's coagulation potential assessed by this new method is very scarce and confined to children and adults with morbid obesity. 13,14 In addition, the extent to which total fat mass and its distribution contribute to or protect against a hypercoagulable state is not known. It is also unknown what adiposity-related underlying mechanisms may explain any such associations, but low-grade inflammation is a likely candidate in this regard.…”

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confidence: 99%

Body Composition as Determinant of Thrombin Generation in Plasma

Beijers

Ferreira

Spronk

et al. 2010

ATVB

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Objective-The association between obesity and cardiovascular disease and venous thromboembolism might, at least partially, be explained by a hypercoagulable state. The extent to which body fat mass and its distribution contribute to a hypercoagulable state is unknown. In this study, we investigated the association between body composition and thrombin generation and evaluated the potential mediating role of low-grade inflammation. Methods and Results-We studied 586 individuals from the Hoorn Study (mean age, 69.7Ϯ6.5 years, 298 women) in whom body composition was assessed by whole body dual-energy absorptiometry. Thrombin generation was measured using the Calibrated Automated Thrombogram. Multiple regression analyses showed a positive association between total body fat and thrombin generation in women but not in men. In addition, detailed analyses of regional body composition showed that central but not peripheral fat mass was associated with greater thrombin generation and that there was a trend toward an inverse association with peripheral lean mass. The reported positive associations were partially attenuated by low-grade inflammation, however. Conclusion-Body fat mass, in particular a central pattern of fat distribution, is associated with higher levels of thrombin generation in elderly women but not in men. This association may partially be explained by adiposity-related low-grade inflammation, but this hypothesis needs to be further investigated in mechanistic/prospective studies. (Arterioscler

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Thrombin generation in severely obese children

Cited by 31 publications

References 18 publications

Thrombin generation in morbid obesity: significant reduction after weight loss

Thrombin generation in morbid obesity: significant reduction after weight loss

Diet Modulates Endogenous Thrombin Generation, A Biological Estimate of Thrombosis Risk, Independently of the Metabolic Status

Body Composition as Determinant of Thrombin Generation in Plasma

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