Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Clinical Studies and Practice

Decrease in microvesicle-associated tissue factor activity in morbidly obese patients after bariatric surgery

International Journal of Obesity volume 40, pages 768–772 (2016)Cite this article

Subjects

Abstract

Background:

Tissue factor (TF) is the main in vivo initiator of the blood coagulation cascade. Active circulating TF was detected on small, negatively charged membrane vesicles, the so-called microvesicles (MVs), which are released upon cell activation and apoptosis from a variety of cells. Increased coagulation activation was found in morbidly obese patients, and elevated levels of TF-bearing MVs may contribute to the prothrombotic state in these patients.

Aim:

To determine MV-associated TF activity levels in morbidly obese patients before and after weight loss due to bariatric surgery.

Methods:

MV-TF activity was measured with a factor Xa generation assay in morbidly obese patients before and 2 years after bariatric surgery. In addition, clinical parameters were determined.

Results:

Seventy-four morbidly obese patients (mean age: 42 (±11) years; 61 females) were included in this study. After bariatric surgery, the body mass index decreased from (median, 25–75th percentile) 45.5 (42.3–50.2) to 30.5 (28.0–34.4 kg m−2; P<0.001), and a significant improvement in metabolic parameters was observed. Preoperative MV-TF activity correlated with C-reactive protein levels (r=0.3; P=0.02). Postoperatively, the mean MV-TF activity decreased significantly from 0.20 pg ml−1 (0.18–0.47) to 0.02 (0.00–0.28; P<0.01).

Conclusion:

We could demonstrate a significant decrease in MV-TF activity after weight loss in morbidly obese patients. Decreased MV-TF activity might contribute to an improved coagulation profile in these patients after weight loss.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Adams KF, Schatzkin A, Harris TB, Kipnis V, Mouw T, Ballard-Barbash R et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 2006; 355: 763–778.

    Article  CAS  Google Scholar 

  2. Goldhaber SZ, Savage DD, Garrison RJ, Castelli WP, Kannel WB, McNamara PM et al. Risk factors for pulmonary embolism. The Framingham Study. Am J Med 1983; 74: 1023–1028.

    Article  CAS  Google Scholar 

  3. Stevens J, Cai J, Pamuk ER, Williamson DF, Thun MJ, Wood JL . The effect of age on the association between body-mass index and mortality. N Engl J Med 1998; 338: 1–7.

    Article  CAS  Google Scholar 

  4. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr . Body-mass index and mortality in a prospective cohort of US adults. N Engl J Med 1999; 341: 1097–1105.

    Article  CAS  Google Scholar 

  5. Pontiroli AE, Folli F, Paganelli M, Micheletto G, Pizzocri P, Vedani P et al. Laparoscopic gastric banding prevents type 2 diabetes and arterial hypertension and induces their remission in morbid obesity: a 4-year case-controlled study. Diabetes Care 2005; 28: 2703–2709.

    Article  Google Scholar 

  6. Kopp HP, Kopp CW, Festa A, Krzyzanowska K, Kriwanek S, Minar E et al. Impact of weight loss on inflammatory proteins and their association with the insulin resistance syndrome in morbidly obese patients. Arterioscler Thromb Vasc Biol 2003; 23: 1042–1047.

    Article  CAS  Google Scholar 

  7. Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357: 741–752.

    Article  Google Scholar 

  8. Darvall KA, Sam RC, Silverman SH, Bradbury AW, Adam DJ . Obesity and thrombosis. Eur J Vasc Endovasc Surg 2007; 33: 223–233.

    Article  CAS  Google Scholar 

  9. Ay C, Tengler T, Vormittag R, Simanek R, Dorda W, Vukovich T et al. Venous thromboembolism—a manifestation of the metabolic syndrome. Haematologica 2007; 92: 374–380.

    Article  CAS  Google Scholar 

  10. Ageno W, Prandoni P, Romualdi E, Ghirarduzzi A, Dentali F, Pesavento R et al. The metabolic syndrome and the risk of venous thrombosis: a case-control study. J Thromb Haemost 2006; 4: 1914–1918.

    Article  CAS  Google Scholar 

  11. Samad F, Ruf W . Inflammation, obesity, and thrombosis. Blood 2013; 122: 3415–3422.

    Article  CAS  Google Scholar 

  12. Goichot B, Grunebaum L, Desprez D, Vinzio S, Meyer L, Schlienger JL et al. Circulating procoagulant microparticles in obesity. Diabetes Metab 2006; 32: 82–85.

    Article  CAS  Google Scholar 

  13. Tesselaar ME, Romijn FP, Van Der Linden IK, Prins FA, Bertina RM, Osanto S . Microparticle-associated tissue factor activity: a link between cancer and thrombosis? J Thromb Haemost 2007; 5: 520–527.

    Article  CAS  Google Scholar 

  14. Manly DA, Wang J, Glover SL, Kasthuri R, Liebman HA, Key NS et al. Increased microparticle tissue factor activity in cancer patients with Venous Thromboembolism. Thromb Res 2010; 125: 511–512.

    Article  CAS  Google Scholar 

  15. Langer F, Spath B, Haubold K, Holstein K, Marx G, Wierecky J et al. Tissue factor procoagulant activity of plasma microparticles in patients with cancer-associated disseminated intravascular coagulation. Ann Hematol 2008; 87: 451–457.

    Article  CAS  Google Scholar 

  16. Thaler J, Pabinger I, Sperr WR, Ay C . Clinical evidence for a link between microparticle-associated tissue factor activity and overt disseminated intravascular coagulation in patients with acute myelocytic leukemia. Thromb Res 2014; 133: 303–305.

    Article  CAS  Google Scholar 

  17. Thaler J, Koppensteiner R, Pabinger I, Ay C, Gremmel T . Microparticle-associated tissue factor activity in patients with acute unprovoked deep vein thrombosis and during the course of one year. Thromb Res 2014; 134: 1093–1096.

    Article  CAS  Google Scholar 

  18. National Institutes of Health Consensus Development Conference Statement. Gastrointestinal surgery for severe obesity. Am J Clin Nutr 1992; 55 (Suppl): 615S–619S.

    Google Scholar 

  19. Kriwanek S, Tuchmann A . Gastric bypass in the management of morbid obesity. Wien Klin Wochenschr 1989; 101: 617–621.

    CAS  PubMed  Google Scholar 

  20. Mason EE, Doherty C, Cullen JJ, Scott D, Rodriguez EM, Maher JW . Vertical gastroplasty: evolution of vertical banded gastroplasty. World J Surg 1998; 22: 919–924.

    Article  CAS  Google Scholar 

  21. American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care Jan 2014; 37 (Suppl 1): S14–S80.

    Article  Google Scholar 

  22. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419.

    Article  CAS  Google Scholar 

  23. Khorana AA, Francis CW, Menzies KE, Wang JG, Hyrien O, Hathcock J et al. Plasma tissue factor may be predictive of venous thromboembolism in pancreatic cancer. J Thromb Haemost 2008; 6: 1983–1985.

    Article  CAS  Google Scholar 

  24. Lee RD, Barcel DA, Williams JC, Wang JG, Boles JC, Manly DA et al. Pre-analytical and analytical variables affecting the measurement of plasma-derived microparticle tissue factor activity. Thromb Res 2012; 129: 80–85.

    Article  CAS  Google Scholar 

  25. Adams M . Assessment of thrombin generation: useful or hype? Semin Thromb Hemost 2009; 35: 104–110.

    Article  Google Scholar 

  26. Samad F, Pandey M, Loskutoff DJ . Tissue factor gene expression in the adipose tissues of obese mice. Proc Natl Acad Sci USA 1998; 95: 7591–7596.

    Article  CAS  Google Scholar 

  27. Samad F, Pandey M, Loskutoff DJ . Regulation of tissue factor gene expression in obesity. Blood 2001; 98: 3353–3358.

    Article  CAS  Google Scholar 

  28. Badeanlou L, Furlan-Freguia C, Yang G, Ruf W, Samad F . Tissue factor-protease-activated receptor 2 signaling promotes diet-induced obesity and adipose inflammation. Nat Med 2011; 17: 1490–1497.

    Article  CAS  Google Scholar 

  29. Diamant M, Nieuwland R, Pablo RF, Sturk A, Smit JW, Radder JK . Elevated numbers of tissue-factor exposing microparticles correlate with components of the metabolic syndrome in uncomplicated type 2 diabetes mellitus. Circulation 2002; 106: 2442–2447.

    Article  CAS  Google Scholar 

  30. Ayer JG, Song C, Steinbeck K, Celermajer DS, Ben Freedman S . Increased tissue factor activity in monocytes from obese young adults. Clin Exp Pharmacol Physiol 2010; 37: 1049–1054.

    Article  CAS  Google Scholar 

  31. Kopp CW, Kopp HP, Steiner S, Kriwanek S, Krzyzanowska K, Bartok A et al. Weight loss reduces tissue factor in morbidly obese patients. Obes Res 2003; 11: 950–956.

    Article  Google Scholar 

  32. Geddings JE, Mackman N . Comment on 'tissue factor expressed by microparticles is associated with mortality but not with thrombosis in cancer patients'. Thromb Haemost 2013; 111: 180–181.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Tanja Altreiter (Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna) for proofreading this manuscript.

Author information

Authors and Affiliations

  1. Department of Internal Medicine I, Rudolfstiftung Hospital Vienna, Vienna, Austria

    L Ay, J-M Brix & G Schernthaner

  2. Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria

    J Thaler, C Ay & I Pabinger

  3. Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria

    G H Schernthaner

Authors
  1. L Ay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Thaler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J-M Brix
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G H Schernthaner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C Ay
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. I Pabinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G Schernthaner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I Pabinger.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ay, L., Thaler, J., Brix, JM. et al. Decrease in microvesicle-associated tissue factor activity in morbidly obese patients after bariatric surgery. Int J Obes 40, 768–772 (2016). https://doi.org/10.1038/ijo.2015.246

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2015.246

This article is cited by

Search

Advanced search

Quick links