Obesity and Thrombosis

• Published in: European journal of vascular and endovascular surgery Vol. 33; no. 2; pp. 223 - 233
• Main Authors: Darvall, K.A.L, Sam, R.C, Silverman, S.H, Bradbury, A.W, Adam, D.J
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2007
• Subjects: Adiponectin; Adiponectin - blood; Global Health; Humans; Leptin; Leptin - blood; Metabolic syndrome; Morbidity - trends; Obesity; Obesity - blood; Obesity - complications; Risk Factors; Surgery; Thrombosis; Thrombosis - epidemiology; Thrombosis - etiology; Venous thromboembolism; Obesity; Metabolic syndrome; Thrombosis; Leptin; Venous thromboembolism; Adiponectin
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2006.10.006

Objectives To describe the pathophysiological mechanisms by which obesity increases the propensity to thrombosis, the leading cause of death in the Western World, with particular emphasis on the role of inflammation, oxidative stress, dyslipidaemia, insulin resistance and the coagulation cascade. Design Review article. Materials and methods Medline (1966–2005) and Cochrane library review of literature examining the relationship between obesity and thrombosis. Search terms included obesity, overweight, body mass index, thrombosis, cardiovascular disease, venous thromboembolism, peripheral arterial disease, and coronary heart disease. Results Obesity is an important and growing public health issue that is estimated to affect more than half of the UK adult population. Obesity, in particular central (visceral) obesity, is associated with significant, and largely preventable, morbidity and mortality including an increased incidence and prevalence of arterial and venous thrombotic events. The various mechanisms by which obesity may cause thrombosis include: the actions of so-called adipocytokines from adipose tissue, e.g. leptin and adiponectin; increased activity of the coagulation cascade and decreased activity of the fibrinolytic cascade; increased inflammation; increased oxidative stress and endothelial dysfunction; and disturbances of lipids and glucose tolerance in association with the metabolic syndrome. Conclusions Obesity appears to be associated with thrombosis via several mechanisms. These pro-thrombotic factors are all improved by weight loss.