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Body mass index reduction improves the baseline procoagulant imbalance of obese subjects

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Abstract

Obesity is a risk factor for cardiovascular diseases. The latter being dependent (at least in part) on plasma procoagulant imbalance (i.e., hypercoagulability). Information on hypercoagulability associated with obesity is scanty and mainly based on global traditional coagulation tests or on the measurement of individual components of coagulation (i.e., pro- and anticoagulants). Plasma from 33 obese subjects was investigated soon before endoscopic balloon placement and after removal (6 months later) by thrombin-generation procedures that are thought to represent much better than any other in vitro test the coagulation process occurring in vivo. We found that obese subjects possess a state of hypercoagulability as demonstrated by the modification of the main parameters of thrombin-generation. In particular, the median value (min–max) of the endogenous thrombin potential (ETP) of obese subjects at baseline was higher than that of controls [1968 (1335–2533) vs. 1710 (1010–2119), p < 0.001]. Endoscopic balloon placement achieved a BMI reduction from 38.9 (31.7–62.3) to 31.6 (21.9–53.3), p < 0.001 and a parallel reduction of thrombin-generation as demonstrated by the following findings. The ETP measured soon after balloon removal was significantly smaller than that measured at baseline [1783 (1224–2642) vs. 1968 (1335–2533), p < 0.01]. The other parameters of thrombin-generation, including lag-time, peak-thrombin, time-to-reach the peak and velocity index showed a pattern consistent with the ETP, both at baseline and soon after balloon removal. Endoscopic balloon placement achieves concomitant reduction of BMI and thrombin-generation in subjects with obesity.

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Author information

Authors and Affiliations

  1. IRCCS Cà Granda Maggiore Hospital Foundation, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi villa, Via Pace 9, 20122, Milano, Italy

    Armando Tripodi, Marigrazia Clerici, Lidia Padovan, Veena Chantarangkul, Erica Scalambrino & Flora Peyvandi

  2. Division of Gastroenterology and Hepatology, IRCCS Cà Granda Maggiore Hospital Foundation Milano, A.M. and A. Migliavacca Center for Liver Disease, Milano, Italy

    Massimo Primignani & Giulia Tosetti

  3. Divisione di Chirurgia Generale, IRCCS Cà Granda Maggiore Hospital Foundation Milano, Milano, Italy

    Sara Badiali, Fausto de Ruberto & Paola Granelli

  4. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy

    Flora Peyvandi

Authors
  1. Armando Tripodi
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  2. Massimo Primignani
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  3. Sara Badiali
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  4. Fausto de Ruberto
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  5. Paola Granelli
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  6. Giulia Tosetti
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  7. Marigrazia Clerici
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  8. Lidia Padovan
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  9. Veena Chantarangkul
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  10. Erica Scalambrino
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  11. Flora Peyvandi
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Contributions

AT and MP conceived and supervised the study. AT wrote the manuscript. SB, FdB and PG enrolled and managed patients. GT collected data. MC, LP, VC and ES, tested samples. VC managed data and made statistical analyses. FP and all the other authors reviewed data and revised the manuscript.

Corresponding author

Correspondence to Armando Tripodi.

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The authors declare that they have no conflict of interest.

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Tripodi, A., Primignani, M., Badiali, S. et al. Body mass index reduction improves the baseline procoagulant imbalance of obese subjects. J Thromb Thrombolysis 48, 52–60 (2019). https://doi.org/10.1007/s11239-019-01818-9

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  • DOI: https://doi.org/10.1007/s11239-019-01818-9

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