Obesity, metabolic syndrome, and thrombophilia
Objective. To comprehensively analyze the data available in the current literature on a pathogenetic relationship between obesity and thrombophilia in the development of obstetric and thrombotic events in female patients with metabolic syndrome (MS).Khromylev A.V., Makatsaria A.D.
Material and methods. The review included the data of foreign and Russian articles published in the past 10 years and found in PubMed and e-Library on this topic.
Results. The paper clearly shows possible mechanisms and a pathogenetic relationship between endocrine, proinflammatory, and prothrombotic statuses observed in patients with MS in the development of obstetric and thrombotic events.
Conclusion. Despite a significant number of investigations of the risk factors and pathogenetic mechanisms for the development of thromboembolic events in MS patients, the problem of identifying the causes and ways of correcting the abnormalities has not been fully resolved and requires further study. Moreover, the annually increasing percent of persons with obesity and metabolic syndrome among reproductive-aged women poses new challenges of optimizing their preparation for pregnancy and preventing thrombohemorrhagic complications during pregnancy, delivery, and the postpartum period.
Keywords
metabolic syndrome
obesity
atherosclerosis
thrombotic events
thrombosis
thrombophilia
antithrombotic therapy
Supplementary Materials
References
1. Ageno W., Becattini C., Brighton T., Selby R., Kamphuisen P.W. Cardiovascular risk factors and venous thromboembolism: a meta-analysis. Circulation. 2008; 117(1): 93-102.
2. Kim J.A., Montagnani M., Koh K.K., Quon M.J. Reciprocal relationships between insulin resistance and endothelial dysfunction: molecular and pathophysiological mechanisms. Circulation. 2006; 113(15): 1888-904.
3. Kobashi G., Ohta K., Yamada H., Hata A., Minakami H., Sakuragi N. et al.; Hokkaido Perinatal Epidemiology Study Group. 4G/5G variant of plasminogen activator inhibitor-1 gene and severe pregnancy-induced hypertension: subgroup analyses of variants of angiotensinogen and endothelial nitric oxide synthase. J. Epidemiol. 2009; 19(6): 275-80.
4. Fay W.P., Garg N., Sunkar M. Vascular functions of the plasminogen activation system. Arterioscler. Thromb. Vasc. Biol. 2007; 27(6): 1231-7.
5. Kopp C.W., Kopp H.P., Steiner S., Kriwanek S., Krzyzanowska K., Bartok A. et al. Weight loss reduces tissue factor in morbidly obese patients. Obes. Res. 2003; 11(8): 950-6.
6. Russo I., Traversa M., Bonomo K., De Salve A., Mattiello L., Del Mese P. et al. In central obesity, weight loss restores platelet sensitivity to nitric oxide and prostacyclin. Obesity. 2010; 18(4): 788-97.
7. Gregor M.F., Hotamisligil G.S. Thematic review series: adipocyte biology. Adipocyte stress: the en doplasmic; reticulum and metabolic disease. J. Lipid Res. 2007; 48(9): 1905-14.
8. Бокарев И.Н. Метаболический синдром. Клиническая медицина. 2014; 92(8): 71-6.
9. Boden G. Obesity and free fatty acids. Endocrinol. Metab. Clin. North Am. 2008; 37(3): 635-46.
10. Gaspsyryan A.Y., Ayvazyan L., Mikhailidis D.P., Kitas G.D. Mean platelet volume: a link between thrombosis and inflammation? Curr. Pharm. Des. 2011; 17: 47-58.
11. Арабидзе Г. Г. Клиническая иммунология атеросклероза от теории к практике. Атеросклероз и дислипидемии. 2013; 1: 4-19. [Arabidze G.G. Clinical immunology of atherosclerosis from theory to practice. Ateroskleroz i dislipidemii. 2013; 1: 4-19. (in Russian)]
12. Targher G., Zoppini G., Moghetti P., Day C.P. Disorders of coagulation and hemostasis in abdominal obesity: emerging role of fatty liver. Semin. Thromb. Hemost. 2010; 36(1): 41-8.
13. Hajer G.R., van Haeften T.W., Visseren F.L. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur. Heart J. 2008; 29(24): 2959-71.
14. Maury E., Brichard S.M. Adipokine dysregulation, adipose tissue inflammation and metabolic syndrome. Mol. Cell. Endocrinol. 2010; 314(1): 1-16.
15. Kato H., Kashiwagi H., Shiraga M., Tadokoro S., Kamae T., Ujiie H. et al. Adiponectin acts as an endogenous antithrombotic factor. Arterioscler. Thromb. Vasc. Biol. 2006; 26(1): 224-30.
16. Lumeng C.N., Bodzin J.L., Saltiel A.R. Obesity induces a phenotypic switch in adipose tissue macrophage polarization. J. Clin. Invest. 2007;117(1): 175-84.
17. Аронов Д.М., Лупанов В.П. Некоторые аспекты патогенеза атеросклероза. Атеросклероз и дислипидемии. 2011; 1: 48-56. [Aronov D.M., Lupanov V.P. Some aspects of the pathogenesis of atherosclerosis. Ateroskleroz i dislipidemii. 2011; 1: 48-56. (in Russian)]
18. Ibanez B., Vilahur G., Badimon J.J. Plaque progression and regression in atherothrombosis. J. Thromb. Haemost. 2007; 5(1): 292-9.
19. Nieuwdorp M., Stroes E.S., Meijers J.C., Büller H. Hypercoagulability in the metabolic syndrome. Curr. Opin. Pharmacol. 2005; 5(2): 155-9.
20. Alessi M.C., Juhan-Vague I. Metabolic syndrome, haemostasis and thrombosis. Thromb. Haemost. 2008; 99(6): 995-1000.
21. Bates S.M., Greer I.A., Pabinger I., Sofaer S., Hirsh J. Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008; 133(6, Suppl.): 844S-86S.
22. Randriamboavonjy V., Fleming I. Insulin, insulin resistance, and platelet signaling in diabetes. Diabetes Care. 2009; 32(4): 528-30.
23. Shamshirsaz A.A., Paidas M., Krikun G. Preeclampsia, hypoxia, thrombosis, and inflammation. J. Pregnancy. 2012; 2012: 374047.
24. Anfossi G., Russo I., Trovati M. Platelet dysfunction in central obesity. Nutr. Metab. Cardiovasc. Dis. 2009; 19(6): 440-9.
25. Olufadi R., Byrne C.D. Effects of VLDL and remnant particles on platelets. Pathophysiol. Haemost. Thromb. 2006; 35(3-4): 281-91.
26. Mina A., Favaloro E.J., Koutts J. Hemostatic dysfunction associated with endocrine disorders as a major risk factor and cause of human morbidity and mortality: a comprehensive meta-review. Semin. Thromb. Hemost. 2007; 33(8): 798-809.
27. Jacobsen A.F., Skjeldestad F.E., Sandset P.M. Incidence and risk patterns of venous thromboembolism in pregnancy and puerperium—a register-based casecontrol study. Am. J. Obstet. Gynecol. 2008; 198(2):233. e1-7.
28. Franchini M., Targher G., Montagnana M., Lippi G. The metabolic syndrome and the risk of arterial and venousthrombosis. Thromb. Res. 2008; 122(6):727-35.
29. Nagai N., Hoylaerts M.F., Cleuren A.C., Van Vlijmen B.J., Lijnen H.R. Obesity promotes injury induced femoral artery thrombosis in mice. Thromb. Res. 2008; 122(4): 549-55.
30. Mottillo S., Filion K.B., Genest J., Joseph L., Pilote L., Poirier P. et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J. Am. Coll. Cardiol. 2010; 56(14): 1113-32.
31. Eichinger S., Hron G., Bialonczyk C., Hirschl M., Minar E., Wagner O. et al. Overweight, obesity, and the risk of recurrent venous thromboembolism. Arch. Intern. Med. 2008; 168(15): 1678-83.
32. Poirier P., Giles T.D., Bray G.A., Hong Y., Stern J.S., Pi-Sunyer F.X., Eckel R.H.; American Heart Association; Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Circulation. 2006; 113(6): 898-918.
33. Передеряева Е.Б., Пшеничникова Т.Б., Макацария А.Д. Роль тромбофилии в патогенезе осложнений беременности у женщин с метаболическим синдромом. Практическая медицина. 2013; 7: 32-41. [Perederyaeva E.B., Pshenichnikova T.B., Makatsaria A.D. The role of thrombophilia in the pathogenesis of complications of pregnancy in women with metabolic syndrome. Prakticheskaya meditsina. 2013; 7: 32-41. (in Russian)]
34. Передеряева Е.Б., Пшеничникова Т.Б., Донина Е.В., Макацария А.Д., Капанадзе Д.Л. Течение беременности у женщин с метаболическим синдромом с учетом патогенетической роли тромбофилии. Акушерство, гинекология и репродукция. 2014; 8(1): 60-7. [Perederyaeva EB, Pshenichnikova TB, Donina EV, Makatsaria AD, Kapanadze DL The course of pregnancy in women with metabolic syndrome, taking into account the pathogenetic role of thrombophilia. Akusherstvo, ginekologiya i reproduktsiya. 2014; 8 (1): 60-7. (in Russian)]
35. Макацария А.Д., Пшеничникова Е.Б., Пшеничникова Т.Б., Бицадзе В.О. Метаболический синдром и тромбофилия в акушерстве и гинекологии. М.: МИА; 2006. 480с. [Makatsariya A.D., Pshenichnikova E.B., Pshenichnikova T.B., Bitsadze V.O. Metabolic syndrome and thrombophilia in obstetrics and gynecology. Moscow: MIA; 2006. 480p. (in Russian)]
36. Капанадзе Д.Л. Беременность и роды у женщины с сочетанной тромбофилией, тромбозами и преэклампсией в анамнезе. Акушерство, гинекология и репродукция. 2014; 8(1): 51-3. [Kapanadze D.L. Pregnancy and childbirth in a woman with combined thrombophilia, thrombosis and preeclampsia in the anamnesis. Akusherstvo, ginekologiya i reproduktsiya. 2014; 8 (1): 51-3. (in Russian)]
37. Пшеничникова Т.Б., Передеряева Е.Б., Донина Е.В., Гадаева З.К. Место тромбофилии в структуре синдрома потери плода у женщин с метаболическим синдромом. Акушерство, гинекология и репродукция. 2013; 7(4): 35-43. [Pshenichnikova T.B., Peredyayeva E.B., Donina E.V., Gadaeva Z.K. Place thrombophilia in the structure of fetal loss syndrome in women with metabolic syndrome. Akusherstvo, ginekologiya i reproduktsiya. 2013; 7 (4): 35-43. (in Russian)]
38. Li H., Forstermann U. Nitric oxide in the pathogenesis of vascular disease. J. Pathol. 2000; 190(3): 244-54.
39. Badimon L., Hernandez Vera R., Vilahur G. Atherothrombotic risk in obesity. Hamostaseologie. 2013; 33(4): 259-68.
40. Murakami T., Horigome H., Tanaka K., Nakata Y., Ohkawara K., Katayama Y., Matsui A. Impact of weight reduction on production of platelet-derived microparticles and fibrinolytic parameters in obesity. Thromb. Res. 2007; 119(1): 45-53.
41. Badimon L., Storey R.F., Vilahur G. Update on lipids, inflammation and atherothrombosis. Thromb. Haemost. 2011; 105(1): 34-42.
42. Kidron D., Bernheim J., Aviram R. Placental findings contributing to fetal death, a study of 120 stillbirths between 23 and 40 weeks gestation. Placenta. 2009; 30(8): 700-4.
43. Heerwagen M.J., Miller M.R., Barbour L.A., Friedman J.E. Maternal obesity and fetal metabolic programming: a fertile epigenetic soil. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2010; 299(3): R711-22.
44. James A.H. Venous thromboembolism in pregnancy. Arterioscler. Thromb. Vasc. Biol. 2009; 29(3): 326-31.
45. Хромылев А.В., Макацария А.Д. Противотромботическая терапия у родильниц с метаболическим синдромом после абдоминального родоразрешения. Акушерство, гинекология и репродукция. 2016; 10(3): 11-6. [Khromylev A.V., Makatsariya A.D. Antiplatelet therapy in puerperas with metabolic syndrome after abdominal delivery. Akusherstvo, ginekologiya i reproduktsiya. 2016; 10 (3): 11-6. (in Russian)]
Received 16.01.2017
Accepted 17.02.2017
About the Authors
Khromylev Aleksei Viktorovich, graduate student of the Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University.119048, Russia, Moscow, Trubetskaya str. 8, bld. 2. E-mail: khromilev@mail.ru
Makatsariya Aleksandr Davidovich, MD, corresponding member of the Russian Academy of Sciences, Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Medical and Preventive, I.M. Sechenov First Moscow State Medical University. 119048, Russia, Moscow, Trubetskaya str. 8, bld. 2. Tel.: +74957885840.
E-mail: gemostasis@mail.ru
For citations: Khromylev A.V., Makatsaria A.D. Obesity, metabolic syndrome, and thrombophilia. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (10): 27-33. (in Russian)
https://dx.doi.org/10.18565/aig.2017.10.27-33
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