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 months subsequent to gastric banding. Twenty-five healthy women served as a baseline control group. The obese women had higher CRP (p = 0. 0001), fibrinogen (p = 0. 014), PAI-1 (p = 0. 003), VWF (p = 0. 004) and FVII levels (p = 0. 0001) than the normal controls, and their body mass index (BMI) positively correlated with CRP (r = 0. 462, p = 0. 02), fibrinogen (r = 0. 426, p = 0. 04) and PAI-1 (r = 0. 468, p = 0. 02). Twelve months after gastric banding, the median BMI had decreased from 40. 0 to 34. 9 (p = 0. 0001); CRP from 4. 18 to 1. 69 μg/ml (p = 0. 01); fibrinogen from 389 to 318 mg/dl (p = 0. 0001); PAI-1 from 32. 1 to 12. 0 UI/ml (p = 0. 003); VWF from 144 to 120% (p = 0. 0001); and FVII from 134 to 112% (p = 0. 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.