Obese Subjects Have Low Global Fibrinolytic Capacity Associated with Insulin Resistance

Abstract

Obese subjects frequently have insulin resistance and they are at particularly risk of cardiovascular complications, possibly related to haemostatic and fibrinolytic system dysfunction. The aim of this study was to determine the effects of obesity on global fibrinolytic capacity (GFC) which is a new test used to assess fibrinolytic activity, and to evaluate the relationship of GFC with cardiovascular risk (CVR) factors. Fifty obese subjects, with a body mass index (BMI)> 30 kg/m2 (36 women, 14 men; mean age, 30±7 years; mean BMI, 34±3 kg/m2); and 30 non-obese subjects, with a BMI<25 kg/m2 (19 women, 11 men; mean age, 30±6 years; mean BMI, 22±2kg/m2) were enrolled the study. Anthropometric measurements (weight, height, hip and waist circumferences) were recorded down. Plasma fasting glucose, insulin, lipid profiles, fibrinogen levels, Ddimer and GFC were determined. Insulin resistance was calculated by homeostasis model assessment (HOMA-IR). The gender and age were well matched in the two groups. Mean GFC was significantly lower in obese subjects than non-obese ones (7.6±7.5 μg/ml, 16.3±11.9 μg/ml, P< 0.001). However, there was no difference between mean D-dimer levels of the two groups. Mean plasma levels of fasting glucose (P< 0.05), insulin (P< 0.001), HOMA-IR (P< 0.01), fibrinogen (P< 0.001) in the obese group were higher than in the
non-obese group. GFC showed inverse correlations with HOMA-IR (r=-0,41, P<0,001) and fasting insulin (r=-0,30, P<0,05). These data showed that obese subjects have a net hypofibrinolytic state which is associated insulin resistance.