Inflammatory and prothrombotic parameters in normotensive non-diabetic obese women : effect of weight loss obtained by gastric banding

Hypertension and diabetes are known risk factors for obesity-related thrombosis, but several studies have shown that obesity is characterised by a potentially prothrombotic inflammatory state because of activated coagulation and impaired fibrinolysis. In order to verify if obese patients-unaffected by hypertension, diabetes, dyslipidemia, cigarette smoking or inflammatory diseases-show increased prothrombotic markers and whether the weight loss induced by gastric banding normalises such parameters. Plasma levels of C reactive protein (CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (VWF) and factor VII (FVII) were measured in 25 women with isolated obesity prior to, as well as 3, 6 and 12\ua0months subsequent to gastric banding. Twenty-five healthy women served as a baseline control group. The obese women had higher CRP (p\ua0=\ua00.0001), fibrinogen (p\ua0=\ua00.014), PAI-1 (p\ua0=\ua00.003), VWF (p\ua0=\ua00.004) and FVII levels (p\ua0=\ua00.0001) than the normal controls, and their body mass index (BMI) positively correlated with CRP (r\ua0=\ua00.462, p\ua0=\ua00.02), fibrinogen (r\ua0=\ua00.426, p\ua0=\ua00.04) and PAI-1 (r\ua0=\ua00.468, p\ua0=\ua00.02). Twelve months after gastric banding, the median BMI had decreased from 40.0 to 34.9 (p\ua0=\ua00.0001); CRP from 4.18 to 1.69\ua0\u3bcg/ml (p\ua0=\ua00.01); fibrinogen from 389 to 318\ua0mg/dl (p\ua0=\ua00.0001); PAI-1 from 32.1 to 12.0\ua0UI/ml (p\ua0=\ua00.003); VWF from 144 to 120% (p\ua0=\ua00.0001); and FVII from 134 to 112% (p\ua0=\ua00.002). Even in the absence of major cardiovascular risk factors, obese patients are characterised by a prothrombotic state. The weight loss induced by gastric banding decreases the parameters of inflammation, coagulation and impaired fibrinolysis, thus potentially reducing the thrombotic risk