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Hemostatic balance alterations in obese children
Insights
Obese children show impaired fibrinolytic response and altered clotting parameters, similar to obese adults. These findings suggest early changes in blood clotting balance in childhood obesity.
Area of Science:
- Pediatric Endocrinology
- Hematology
- Metabolic Disorders
Background:
- Childhood obesity is associated with metabolic abnormalities, including higher blood glucose, cholesterol, and insulin levels.
- Obesity in adults is linked to impaired fibrinolytic activity and altered coagulation, increasing thrombotic risk.
Purpose of the Study:
- To investigate the fibrinolytic response and other clotting parameters in obese children compared to normal-weight controls.
- To assess potential early alterations in the clotting balance in prepubertal obese children.
Main Methods:
- Fibrinolytic response to venous occlusion and clotting parameters (ATIII, F VIII:C, F VIII:R Ag) were measured in obese children and controls.
- Platelet aggregation capacity was assessed using the Breddin method in a larger cohort of obese and normal prepubertal children.
Main Results:
- Obese children exhibited a significantly poorer fibrinolytic response after venous occlusion compared to controls (203.2 vs. 114.7 min, p<0.01).
- Lower levels of Antithrombin III (ATIII) were observed in obese children (p<0.01), with no significant changes in Factor VIII.
- Platelet aggregation capacity was altered in a high proportion of obese children (p<0.05).
Conclusions:
- Obese children demonstrate impaired fibrinolysis and altered platelet aggregation, indicating an early shift in the clotting balance.
- These hemostatic abnormalities in obese children resemble those seen in obese adults, suggesting a potential predisposition to thrombotic events.
- The findings highlight the need for early intervention strategies to address clotting dysregulation in pediatric obesity.
Abstract:
Fibrinolytic response to venous occlusion and other clotting parameters were studied in 34 obese children and 16 controls. The obese children (mean age 9 2/12 years) had a mean overweight of 51.8% +/- 15.6, higher blood glucose and cholesterol levels, and increased baseline and glucose-induced insulinemia. However, baseline ELT did not differ significantly; ELT after 5 min venous occlusion was 203.2 +/- 110.9 min in the obese children and 114.7 +/- 67.9 min in the control group (p less than 0.01) with a mean percent decrease respectively of 14.9% and 29.2%. Poor fibrinolytic responders did not correlate with age, overweight, or metabolic indices. Lower levels of ATIII (p less than 0.01) and no changes in F VIII: C and F VIII: R Ag were also found in the obese. Furthermore, in a larger group of 84 prepubertal obese children (mean age 10 years; mean overweight 48.2%) and in 39 normal prepubertal children (mean age 10 4/12 years) we also studied platelet aggregation capacity according to Breddin. This parameter was altered in a high proportion of the obese children (p less than 0.05). The obese children were also poor fibrinolytic responders, similarly to obese adults, and exhibited early alteration of the clotting balance.