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Increased BMI and Blood Lipids Are Associated With a Hypercoagulable State in the Moli-sani Cohort



doi: 10.3389/fcvm.2022.897733.


eCollection 2022.

Affiliations

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Romy de Laat-Kremers et al.


Front Cardiovasc Med.


.

Abstract

The coagulation system can be assessed by the thrombin generation (TG) assay, and increased TG peak height, endogenous thrombin potential (ETP), and velocity index are associated with an increased risk of thrombosis. Obesity had been reported to increase TG and is associated with dyslipidemia, which also predisposes to atherosclerotic cardiovascular disease (CVD). However, the effect of the blood lipid profile on TG has not been studied extensively. To gain more insight into the associations of TG, body mass index (BMI) and lipid profile, we studied TG in relation to these parameters in a large Italian population cohort, the Moli-sani study (N = 22,546; age ≥ 35 years; 48% men). TG was measured in plasma samples collected at the enrollment of subjects in the Moli-sani study. TG was triggered with 1 or 5 pM tissue factor, and TG parameters lag time, peak, ETP, time-to-peak (TTP) and velocity index (VI). Additionally, thrombomodulin was added to assess the function of the activated protein C system during TG. In both women and men, overweight (BMI 25-30 kg/m2) and obesity (BMI > 30 kg/m2) were significantly associated with higher ETP, peak and VI (all p < 0.001). High total cholesterol, triglycerides and LDL-cholesterol levels were significantly associated with increased ETP and peak (all p < 0.001). Linear regression analysis revealed that the ETP is positively associated with both plasma LDL and HDL cholesterol levels, whereas the velocity index is positively associated with HDL cholesterol. Additionally, ETP, peak and VI were significantly associated with the plasma triglycerides content. In conclusion, our study shows significant associations of high BMI and blood lipid levels with increased TG parameters, and this hypercoagulability may partly explain the increased risk of CVD in individuals with obesity and/or dyslipidemia.


Keywords:

BMI; Moli-sani; lipids; thrombin; thrombin generation.

Conflict of interest statement

Synapse Research Institute is a non-for-profit organization, member of Diagnostica Stago SAS. RdLK, LvdV, MN, DH, CB, DY, and BdL are employees of Synapse Research Institute. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures



Figure 1

Flowchart of selection of the studied population among Moli-sani participants. The groups of eliminated participants (of the 24 325 recruited at baseline) overlap and the scheme shows sequential exclusion criteria. Therefore, the patients in each eliminated group do not fulfill the previous elimination criteria, but it is possible that patients on VKAs were previously eliminated because of e.g., insufficient plasma volume for thrombin generation.

References

    1. Global Status Report on Noncommunicable Diseases . Geneva: World Health Organization (2014).

    1. Lusis AJ. Atherosclerosis. Nature. (2000) 407:233–41. 10.1038/35025203



      DOI



      PMC



      PubMed

    1. Tarchalski J, Guzik P, Wysocki H. Correlation between the extent of coronary atherosclerosis and lipid profile. Mol Cell Biochem. (2003) 246:25–30. 10.1007/978-1-4615-0298-2_4



      DOI



      PubMed

    1. Law MR, Wald NJ, Rudnicka AR. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ. (2003) 326:1423. 10.1136/bmj.326.7404.1423



      DOI



      PMC



      PubMed

    1. Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, et al. . Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. (2007) 370:1829–39. 10.1016/S0140-6736(07)61778-4



      DOI



      PubMed



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