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Hemostatic function in young subjects with central obesity: relationship with left ventricular function
G Licata1, R Scaglione, G Avellone
1Department of Internal Medicine, University of Palermo, Italy.
Insights
Young obese individuals with central fat distribution exhibit altered coagulation and fibrinolysis, impacting left ventricular function. These changes include elevated clotting factors and reduced cardiac efficiency, highlighting risks associated with obesity.
Area of Science:
- Cardiology
- Metabolic Health
- Hematology
Background:
- Obesity, particularly central fat distribution, is linked to cardiovascular disease.
- Coagulation and fibrinolysis play critical roles in cardiovascular health.
- The impact of central obesity on cardiac function and hemostasis in young adults requires further investigation.
Purpose of the Study:
- To evaluate coagulation and fibrinolysis activity in young obese subjects with central fat distribution.
- To assess the relationship between these hemostatic parameters and left ventricular function.
- To compare these measures against lean individuals.
Main Methods:
- Assessed coagulation/fibrinolysis markers (Factor VII, fibrinogen, plasminogen, PAI, tPA) basally and post-occlusion.
- Measured metabolic markers (glucose, lipids, insulin, apo A1/B).
- Evaluated left ventricular function (LVEF, PFR) and mass (LVM/H); assessed central obesity via WHR.
Main Results:
- Obese subjects showed higher Factor VII, fibrinogen, plasminogen, PAI, tPA1, glucose, apo B, and insulin.
- Obese subjects exhibited lower HDL cholesterol, tPA2, LVEF, and PFR.
- WHR correlated with fibrinogen and tPA2; LVEF with tPA1, PAI, fibrinogen; PFR with Factor VII activity.
Conclusions:
- Young obese individuals with central obesity display a prothrombotic state and impaired fibrinolysis.
- These hemostatic alterations are associated with reduced left ventricular function.
- Central obesity significantly impacts both cardiovascular and hemostatic systems in young adults.
Abstract:
This study was designed to evaluate coagulation and fibrinolysis activity and their relationship with left ventricular function in young obese subjects with central fat distribution. We assessed coagulation and fibrinolysis activity by evaluation of factor VII activity, fibrinogen and plasminogen, plasminogen activator inhibitor (PAI), and tissue plasminogen activator antigen basally (tPA1) and after venous occlusion (tPA2). These measures were evaluated in young (< 40 years) obese subjects with central fat distribution (n = 19) and in comparable lean subjects (n = 20). Blood glucose, triglycerides, total and high-density lipoprotein (HDL) cholesterol, apolipoprotein (apo) A1 and apo B, fasting immunoreactive insulin, and lipoprotein(a) levels were also measured by current methods. Left ventricular ejection fraction (LVEF) and peak filling rate (PFR) determined by radionuclide angiocardiography and left ventricular mass (LVM) and LVM indexed for body height (LVM/H) determined by echocardiographic study were calculated. Central obesity was evaluated by the waist to hip ratio (WHR) according to the criteria of the Italian Consensus Conference of Obesity. Factor VII (P < .001), fibrinogen (P < .001), plasminogen (P < .001), PAI activity (P < .001), tPA1 (P < .02), fasting blood glucose (P < .01), apo B (P < .02), and immunoreactive insulin (P < .01) were significantly higher in obese than in lean subjects. In contrast, HDL cholesterol (P < .01), tPA2 (P < .01), LVEF (P < .001), and PFR (P < .02) were significantly lower in obese than in lean subjects. In all subjects, WHR correlated directly with fibrinogen and inversely with tPA2; LVEF correlated inversely with tPA1, PAI, and fibrinogen; and PFR correlated inversely with factor VII activity.(ABSTRACT TRUNCATED AT 250 WORDS)