Bariatric patients have plasmatic hypercoagulability and systemic upregulation of heme oxygenase activity.

TitleBariatric patients have plasmatic hypercoagulability and systemic upregulation of heme oxygenase activity.
Publication TypeJournal Article
Year of Publication2015
AuthorsNielsen VG, Galvani CA, Boyle PK, Steinbrenner EB, Matika RW
JournalBlood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
Volume26
Issue2
Pagination200-4
Date Published2015 Mar
ISSN1473-5733
Abstract

Morbid obesity is associated with significant thrombophilia. Of interest, adipocytes obtained from obese patients have increased heme oxygenase (Hmox) activity, the endogenous enzyme responsible for carbon monoxide (CO) production. Given that CO enhances plasmatic coagulation, we determined whether morbidly obese patients undergoing bariatric surgery had an increase in endogenous CO and plasmatic hypercoagulability. CO was determined by noninvasive pulse oximetry measurement of carboxyhemoglobin (COHb). A thrombelastographic method to assess plasma coagulation kinetics and formation of carboxyhemefibrinogen (COHF) was utilized. Nonsmoking bariatric patients (n = 20, BMI 47 ± 8 kg/m, mean ± SD) had abnormally increased COHb concentrations of 2.7 ± 1.9%, indicative of Hmox upregulation. When coagulation kinetics of these bariatric patients were compared with values obtained from normal individuals' (n = 30) plasma, 70% (95% confidence interval 45.7-88.1%) had abnormally great velocity of clot formation, abnormally large clot strength, and COHF formation. Future investigation of Hmox-derived CO in the pathogenesis of obesity-related thrombophilia is warranted.

DOI10.1097/MBC.0000000000000194
Alternate JournalBlood Coagul. Fibrinolysis