Solá Eva, Vayá Amparo, España Francisco, Castelló Remedios, Ramón Luis A, Hernández-Mijares Antonio, Vicente Vicente, Estellés Amparo
Endocrinology Service, Doctor Peset University Hospital, Av. Gaspar Aguilar, 90. 46017 Valencia, Spain.
Thromb Res. 2008;122(3):320-7. doi: 10.1016/j.thromres.2007.10.016. Epub 2007 Nov 26.
An association between an increase in plasminogen activator inhibitor type 1 and obesity has been described. It has also been shown that a decrease in adiposity has beneficial effects. However, less information is available regarding morbid obesity and hypofibrinolysis. The aim of the present study was to evaluate the effect of weight loss and the influence of the plasminogen activator inhibitor type 1 promoter 4G/5G genotype on plasminogen activator inhibitor type 1 levels in severe and morbid obesity.
Sixty-seven obese patients were studied before and three months after a weight reduction program, and compared with 67 controls. We determined plasminogen activator inhibitor type 1 antigen and activity levels, tissue type plasminogen activator antigen levels, 4G/5G genotype and biochemical parameters in both groups.
A significant increase in plasminogen activator inhibitor type 1 antigen and activity was observed in obese patients in comparison with the control group (P<0.001). No significant differences in plasminogen activator inhibitor type 1 levels among 4G/5G genotypes were obtained. After weight loss, a significant decrease in plasminogen activator inhibitor type 1 antigen and activity was observed (P<0.001). A significant and positive correlation was observed in percentage changes in plasminogen activator inhibitor type 1 and body mass index (P=0.02).
A decrease in body mass index in severe and morbid obesity shows a favourable effect on the fibrinolytic system due to a decrease in plasminogen activator inhibitor type 1 levels. However, no influence of 4G/5G polymorphism has been observed in this setting.
纤溶酶原激活物抑制剂1水平升高与肥胖之间的关联已被描述。也有研究表明，肥胖程度降低具有有益作用。然而，关于病态肥胖和纤溶功能低下的信息较少。本研究的目的是评估体重减轻的影响以及纤溶酶原激活物抑制剂1启动子4G/5G基因型对重度和病态肥胖患者纤溶酶原激活物抑制剂1水平的影响。
对67例肥胖患者在减重计划实施前和实施三个月后进行研究，并与67例对照组进行比较。我们测定了两组患者的纤溶酶原激活物抑制剂1抗原和活性水平、组织型纤溶酶原激活物抗原水平、4G/5G基因型以及生化参数。
与对照组相比，肥胖患者的纤溶酶原激活物抑制剂1抗原和活性显著升高（P<0.001）。4G/5G基因型之间的纤溶酶原激活物抑制剂1水平无显著差异。体重减轻后，纤溶酶原激活物抑制剂1抗原和活性显著降低（P<0.001）。纤溶酶原激活物抑制剂1的百分比变化与体重指数之间存在显著正相关（P=0.02）。
重度和病态肥胖患者体重指数的降低对纤溶系统有有利影响，因为纤溶酶原激活物抑制剂1水平降低。然而，在这种情况下未观察到4G/5G多态性的影响。
