Coagulation and fibrinolysis abnormalities in obesity

De Pergola, Giovanni; Pannacciulli, N.

doi:10.1007/bf03344054

Cited by 206Blood Coagulation and Thrombosis MechanismsAdipokines, Inflammation, and Metabolic DiseasesBlood properties and coagulation

Coagulation and fibrinolysis abnormalities in obesity

De Pergola, Giovanni, Pannacciulli, N.·2002·Journal of Endocrinological Investigation

DOI 10.1007/bf03344054

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Abstract

Abnormalities in coagulation and haemostasis represent a well-known link between obesity and thrombosis (both arterial and venous). Several studies have shown that obese patients have higher plasma concentrations of all pro-thrombotic factors (fibrinogen, vonWillebrand factor (vWF), and factor VII), as compared to non-obese controls, with a positive association with central fat. Similarly, plasma concentrations of plasminogen activator inhibitor-1 (PAI-1) have been shown to be higher in obese patients as compared to non-obese controls and to be directly correlated with visceral fat. Furthermore, obesity is characterized by higher plasma concentrations of anti-thrombotic factors, such as tissue-type plasminogen activator (t-PA) and protein C, as compared to non-obese controls, the increase in these factors being likely to represent a protective response partly counteracting the increase in pro-thrombotic factors. The issue of whether adipose tissue contributes directly to plasma PAI-1, its products stimulating other cells to produce PAI-1, or whether it primarily contributes indirectly has not yet been resolved. It has been proposed that the secretion of interleukin-6 (IL-6) by adipose tissue, combined with the actions of adipose tissue-expressed TNF-alpha in obesity, could underlie the association of insulin resistance with endothelial dysfunction, coagulopathy, and coronary heart disease. The role of leptin in impairing haemostasis and promoting thrombosis has been recently reported. Finally, some hormonal abnormalities (androgen, F, catecholamines) associated with the accumulation of body fat may contribute to the impairment of coagulative pathway in obesity. As to intervention strategies, dietary (i.e., low-fat high-fiber diet) and lifestyle (i.e., physical activity) measures have been demonstrated to be effective in improving the obesity-associated pro-thrombotic risk profile.

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Authors: De Pergola, G., & Pannacciulli, N.
Affiliations: University of Bari Aldo Moro (IT)
Venue: Journal of Endocrinological Investigation
Publisher: Springer Science and Business Media LLC
Published: 2002-11
Volume: 25
Issue: 10
Pages: 899-904
ISSN: 0391-4097 (ISSN-L)
1720-8386
DOI: 10.1007/bf03344054
OpenAlex: W2033958201
Cited by: 206
References: 39
Citations by year: 2026: 8 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 13 · 2021: 9 · 2020: 9 · 2019: 7 · 2018: 8 · 2017: 3 · 2016: 8 · 2015: 7 · 2014: 9 · 2013: 6 · 2012: 8
FWCI: 1.45
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Journal of Endocrinological Investigation (publishedVersion)
PubMed (publishedVersion)
CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
Topics: Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Blood properties and coagulation
Keywords: obesity, coagulopathy, fibrinolysis, thrombosis, hemostasis, plasminogen activator inhibitor-1, tissue plasminogen activator, protein C, fibrinogen, von Willebrand factor, factor VII, visceral fat, adipose tissue, interleukin-6, TNF-α, insulin resistance, endothelial dysfunction, coronary artery disease, leptin, androgens, catecholamines, low-fat high-fiber diet, physical activity
MeSH terms: Adipose Tissue, Blood Coagulation Disorders, Endocrine Glands, Fibrinolysis, Hemostasis, Humans, Insulin Resistance, Obesity, Polymorphism, Genetic, Thrombosis, Plasminogen Activator Inhibitor 1, Leptin

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Coagulation and fibrinolysis abnormalities in obesity

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