Hemostatic variables, carbohydrate metabolism and lipid profile in women with low body mass index

The aim of this study was to evaluate hemostatic variables in women according to different body mass index (BMI) values, and then correlate them with some metabolic parameters - fasting insulin and glucose, total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides. Eighty-four female patients aged 18-39 years were recruited, and agreed to participate in the study. The study group was divided into three subgroups according to BMI: low BMI (BMI < 18.5 kg/m2; n = 43), normal-weight (control) (BMI 18.5-24.99 kg/m2; n = 21) and overweight/obese (BMI > 25 kg/m2; n = 20). BMI was calculated, and the following measurements were taken: International Normalized Ratio, antithrombin III, tissue plasminogen activator (t-PA) activity, t-PA-antigen, plasma fibrinogen level, factor VII, Plasminogen activator inhibitor (PAI)-1 activity and antigen and metabolic parameters: fasting insulin and glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides. The results were statistically analyzed. In the low BMI group, a negative correlation between fasting insulin and PAI-1 activity, and a positive correlation between fasting glucose and PAI-1 antigen were observed. Also, a strong negative correlation between PAI-1 activity and insulin/glucose index was found. Plasma insulin levels were significantly lower in the low-BMI women than in the overweight/obese group (p < 0.001) and with no difference compared to the control group. We did not find any difference in fasting glucose level between all groups. HDL-cholesterol showed the highest levels in the normal BMI group and was significantly higher than in the low BMI and obese groups (p < 0.05 and p < 0.01, respectively). PAI-1 activity in the low BMI women revealed increased activity in comparison to control and overweight/obese women (p < 0.001 and p < 0.05, respectively). Lower antigen levels were also shown as compared to both these groups (p < 0.001 and p < 0.001, respectively). Similar results were obtained with t-PA antigen levels (p < 0.001 and p < 0.001, respectively). There were no differences in activity of t-PA in all groups. Obese women showed significantly higher fibrinogen levels than other BMI groups (p < 0.001 and p < 0.001 respectively). Analysis of hemostatic variables in women with a low BMI testify to the impaired fibrinolysis in this group, also showing a strong correlation with carbohydrate metabolism.