Ukr.Biochem.J. 2023; Volume 95, Issue 4, Jul-Aug, pp. 3-9

doi: https://doi.org/10.15407/ubj95.04.003

Characterization of the blood coagulation system in morbidly obese patients

D. S. Korolova1, O. V. Hornytska1, A. S. Lavrik2,
N. M. Druzhyna1*, N. Prysyazhna3, T. M. Platonova1

1Palladin Institute of Biochemistry, National Academy of Science of Ukraine, Kyiv;
2Shalimov National Institute of Surgery and Transplantation,
National Academy of Medical Sciences of Ukraine, Kyiv;
3Shupyk National Healthcare University of Ukraine, Kyiv;
*e-mail: ndbiochem@gmail.com

Received: 18 April 2023; Revised: 05 May 2023;
Accepted: 7  September 2023; Available on-line:  12 September 2023

Obesity is a complex metabolic disorder that can be followed by blood coagulation disorders, athero­sclerosis and atherothrombosis. In the present work, the levels of fibrinogen, soluble fibrin, D-dimer as well as protein C were measured in the blood plasma of 24 morbidly obese patients (the body mass index exceeds 40 kg/m2) to evaluate the risk of prothrombotic state. The study showed that near by 80% of patients had substantially increased fibrinogen concentration, 33% had increased concentration of soluble fibrin, 42% had increased level of D-dimer in blood plasma as compared to control. According to the results of individual analysis, the high level of fibrinogen and soluble fibrin while reduced protein C indicated the threat of thrombosis, which requires complex diagnostics to be identified. Therefore, simultaneous quantification of hemostatic system biomarkers in the blood plasma is the confident way to predict the risk of thrombotic complications in morbidly obese patients.

Keywords: , , , , ,


References:

  1. King RJ, Ajjan RA. Vascular risk in obesity: Facts, misconceptions and the unknown. Diab Vasc Dis Res. 2017;14(1):2-13. PubMed, CrossRef
  2. Gregg EW, Shaw JE. Global Health Effects of Overweight and Obesity. N Engl J Med. 2017;377(1):80-81. PubMed, CrossRef
  3. Clinical Research Uuraine. Professional portal Available online: https://crupp.org/obesity/
  4. Cominato L, Franco RR, Ybarra M, Frascino AV, Steinmetz L, Ferraro AA, Aivazoglou Carneiro JD, Damiani D. Obesity as a Thrombogenic and Cardiovascular Risk Factor in Children. Horm Res Paediatr. 2021;94(11-12):410-415. PubMed, CrossRef
  5. Grundy SM. Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds. J Am Coll Cardiol. 2006;47(6):1093-1100. PubMed, CrossRef
  6. Lind L, Siegbahn A, Ingelsson E, Sundström J, Arnlöv J. A detailed cardiovascular characterization of obesity without the metabolic syndrome. Arterioscler Thromb Vasc Biol. 2011;31(8):e27-34. PubMed, CrossRef
  7. Morange PE, Alessi MC. Thrombosis in central obesity and metabolic syndrome: mechanisms and epidemiology. Thromb Haemost. 2013;110(4):669-680. PubMed, CrossRef
  8. Blokhin IO, Lentz SR. Mechanisms of thrombosis in obesity. Curr Opin Hematol. 2013;20(5):437-444. PubMed, PubMedCentral, CrossRef
  9. Darvall KAL, Sam RC, Silverman SH, Bradbury AW, Adam DJ. Obesity and thrombosis. Eur J Vasc Endovasc Surg. 2007;33(2):223-233. PubMed, CrossRef
  10. Craft MK, Reed MJ. Venous thromboembolic disease and hematologic considerations in obesity. Crit Care Clin. 2010;26(4):637-640. PubMed, CrossRef
  11. Badimon L, Hernández Vera R, Vilahur G. Atherothrombotic risk in obesity. Hamostaseologie. 2013;33(4):259-268. PubMed, CrossRef
  12. Samad F, Ruf W. Inflammation, obesity, and thrombosis. Blood. 2013;122(20):3415-3422. PubMed, PubMedCentral, CrossRef
  13. Świątkowska-Stodulska R, Kazimierska E, Sworczak K, Częstochowska E. Hemostatic disturbances in obesity. Wiad Lek. 2007;60(3-4):185-188. PubMed
  14. Michalska M, Iwan-Ziętek I, Gniłka W, Dąbrowiecki S, Góralczyk B, Góralczyk K, Drela E, Rość D. PAI-1 and α2-AP in patients with morbid obesity. Adv Clin Exp Med. 2013;22(6):801-807. PubMed
  15. Campello E, Zabeo E, Radu CM, Spiezia L, Gavasso S, Fadin M, Woodhams B, Vettor R, Simioni P. Hypercoagulability in overweight and obese subjects who are asymptomatic for thrombotic events. Thromb Haemost. 2015;113(1):85-96. PubMed, CrossRef
  16. Yuan S, Bruzelius M, Xiong Y, Håkansson N, Åkesson A, Larsson SC. Overall and abdominal obesity in relation to venous thromboembolism. J Thromb Haemost. 2021;19(2):460-469. PubMed, PubMedCentral, CrossRef
  17. Sokolovska AS, Chernyshenko TM, Ivanenko TI. Comparative characteristic of fibrinogen level determination methods in blood plasma. Exper Clin Phisiol Biochem. 2002;(3):82-86. (In Ukrainian).
  18. Nikulnikov PI, Liksunov OV, Ratushnyuk AV, Lugovskoy EV, Kolesnikova IM, Lytvynova LM, Kostyuchenko OP, Chernyshenko TM, Gornytska OV, Platonova TM. Estimation of state of the blood coagulation system after the operation for abdominal aorta aneurysm. Klin Khirurg. 2012;(9):32-36.
  19. Roshan TM, Stein N, Jiang XY. Comparison of clot-based and chromogenic assay for the determination of protein c activity. Blood Coagul Fibrinolysis. 2019;30(4):156-160. PubMed, PubMedCentral, CrossRef
  20. Solá E, Vayá A, Simó M, Hernández-Mijares A, Morillas C, España F, Estellés A, Corella D. Fibrinogen, plasma viscosity and blood viscosity in obesity. Relationship with insulin resistance. Clin Hemorheol Microcirc. 2007;37(4):309-318. PubMed
  21. Ay L, Kopp HP, Brix JM, Ay C, Quehenberger P, Schernthaner GH, Pabinger I, Schernthaner G. Thrombin generation in morbid obesity: significant reduction after weight loss. J Thromb Haemost. 2010;8(4):759-765. PubMed, CrossRef
  22. Kopp CW, Kopp HP, Steiner S, Kriwanek S, Krzyzanowska K, Bartok A, Roka R, Minar E, Schernthaner G. Weight loss reduces tissue factor in morbidly obese patients. Obes Res. 2003;11(8):950-956. PubMed, CrossRef
  23. Jabber HA, Al-Rubaie HA, Alalsaidissa J. The relationship between obesity and plasma level of factor V and fibrinogen. J Fac Med Baghdad. 2017;59(1):53-59. CrossRef
  24. Firszt-Adamczyk A, Ruszkowska-Ciastek B, Adamczyk P, Szafkowski R, Firszt M, Ponikowska I, Moe K, Iwan-Ziętek I, Góralczyk B, Góralczyk K, Rość D. Effect of a 3-Week Low-Calorie Diet and Balneological Treatment on Selected Coagulation Parameters in Morbidly Obese Patients. Adv Clin Exp Med. 2016;25(4):755-761. PubMed, CrossRef
  25. De Pergola G, Pannacciulli N. Coagulation and fibrinolysis abnormalities in obesity. J Endocrinol Invest. 2002;25(10):899-904. PubMed, CrossRef
  26. Bladbjerg EM, Stolberg CR, Juhl CB. Effects of Obesity Surgery on Blood Coagulation and Fibrinolysis: A Literature Review. Thromb Haemost. 2020;120(4):579-591. PubMed, CrossRef
  27. Grover SP, Mackman N. Tissue Factor: An Essential Mediator of Hemostasis and Trigger of Thrombosis. Arterioscler Thromb Vasc Biol. 2018;38(4):709-725. PubMed, CrossRef
  28. Samuels J, Lawson PJ, Morton AP, Moore HB, Hansen KC, Sauaia A, Schoen JA. Prospective assessment of fibrinolysis in morbid obesity: tissue plasminogen activator resistance improves after bariatric surgery. Surg Obes Relat Dis. 2019;15(7):1153-1159. PubMed, PubMedCentral, CrossRef
  29. Singh A, Foster GD, Gunawardana J, McCoy TA, Nguyen T, Vander Veur S, Komaroff E, Rao AK. Elevated circulating tissue factor procoagulant activity, factor VII, and plasminogen activator inhibitor-1 in childhood obesity: evidence of a procoagulant state. Br J Haematol. 2012;158(4):523-527. PubMed, PubMedCentral, CrossRef

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License.