Kopp Christoph W, Kopp Hans-Peter, Steiner Sabine, Kriwanek Stephan, Krzyzanowska Katarzyna, Bartok Andrea, Roka Rudolf, Minar Erich, Schernthaner Guntram
2nd Department of Medicine, Angiology Division, University of Vienna, General Hospital (AKH), Waehringer Guertel 18/20, A-1090 Vienna, Austria.
Obes Res. 2003 Aug;11(8):950-6. doi: 10.1038/oby.2003.131.
To investigate the tissue factor (TF) pathway in clinical obesity and associated metabolic syndrome.
Thirty-seven morbidly obese patients (4 men; BMI, 48 +/- 7 kg/m(2); range, 42 to 53 kg/m(2)), undergoing elective gastroplasty for the induction of weight loss, were examined for hemostatic, metabolic, and inflammatory parameters at baseline and 14 +/- 5 months postoperatively.
Weight loss significantly reduced circulating plasma TF (314 +/- 181 vs. 235 +/- 113 pg/mL, p = 0.04), coagulation factor VII (130 +/- 22% vs. 113 +/- 19%, p = 0.023), and prothrombin fragment F1.2 (2.4 +/- 3.4 vs. 1.14 +/- 1.1 nM, p = 0.04) and normalized glucose metabolism in 50% of obese patients preoperatively classified as diabetic or of impaired glucose tolerance. The postoperative decrease in plasma TF correlated with the decrease of F1.2 (r = 0.56; p = 0.005), a marker of in vivo thrombin formation. In subgroup analysis stratified by preoperative glucose tolerance, baseline circulating TF (402.6 +/- 141.6 vs. 176.2 +/- 58.2, p < 0.001) and TF decrease after gastroplasty (DeltaTF: 164.7 +/- 51.4 vs. -81 +/- 31 pg/mL, p = 0.02) were significantly higher in obese patients with impaired glucose tolerance than in patients with normal glucose tolerance.
Procoagulant TF is significantly reduced with weight loss and may contribute to a reduction in cardiovascular risk associated with obesity.
研究临床肥胖及相关代谢综合征中的组织因子（TF）途径。
37例病态肥胖患者（4例男性；体重指数，48±7kg/m²；范围，42至53kg/m²），接受择期胃成形术以诱导体重减轻，在基线时以及术后14±5个月检查其止血、代谢和炎症参数。
体重减轻显著降低了循环血浆TF（314±181 vs. 235±113 pg/mL，p = 0.04）、凝血因子VII（130±22% vs. 113±19%，p = 0.023）和凝血酶原片段F1.2（2.4±3.4 vs. 1.14±1.1 nM，p = 0.04），并使术前分类为糖尿病或糖耐量受损的肥胖患者中50%的葡萄糖代谢恢复正常。术后血浆TF的降低与F1.2的降低相关（r = 0.56；p = 0.005），F1.2是体内凝血酶形成的标志物。在按术前糖耐量分层的亚组分析中，糖耐量受损的肥胖患者的基线循环TF（402.6±141.6 vs. 176.2±58.2，p < 0.001）和胃成形术后TF的降低（ΔTF：164.7±51.4 vs. -81±31 pg/mL，p = 0.02）显著高于糖耐量正常的患者。
促凝血TF随着体重减轻而显著降低，可能有助于降低与肥胖相关的心血管风险。
