Study of Prothrombotic Changes in Metabolic Syndrome
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ORIGINAL ARTICLE
Study of Prothrombotic Changes in Metabolic Syndrome Jitender Mohan Khunger1 • Nitin Kumar2 • V. P. S. Punia2 Monica Khunger Malhotra3
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Received: 25 December 2019 / Accepted: 12 May 2020 Ó Indian Society of Hematology and Blood Transfusion 2020
Abstract The metabolic syndrome is a complex disorder of various metabolic risk factors in a single individual having central obesity and commonly associated with diabetes and cardiovascular diseases. The aim of our study was to study the relationship between coagulation abnormalities and metabolic syndrome. We performed a prospective cross-sectional study in a tertiary care hospital. A total of fifty cases of metabolic syndrome and fifty age & sex matched controls were selected. These two groups were investigated for Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Fibrinogen levels, Plasminogen Activator Inhibitor 1(PAI1) levels and Factor VIII levels. In cases with metabolic syndrome, significantly increased levels of Fibrinogen, Factor VIII and Plasminogen Activator Inhibitor1 (PAI1) were observed. PT & APTT were shorter in cases with metabolic syndrome. The coagulation parameters studied, correlated significantly with the components of metabolic syndrome. Metabolic syndrome is a hypercoagulable state and further studies are required for further evaluation of the consequences of this hypercoagulable state. There is a need for clinical trials evaluating prophylactic anticoagulation for prevention of venous thrombosis in patients with metabolic syndrome.
& Jitender Mohan Khunger [email protected] 1
Haematology Deptt, Vardhman Mahavir Medical College and Safdar Jang Hospital, New Delhi 110029, India
2
Medicine Department, Vardhman Mahavir Medical College and Safdar Jang Hospital, New Delhi 110029, India
3
Department of Hematology and Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
Keywords Metabolic syndrome Coagulation Prothrombin time (PT) Activated partial thromboplastin time (APTT) Fibrinogen Plasminogen activator inhibitor-1 (PAI-1) Factor VIII
Introduction The Metabolic syndrome is a complex disorder characterized by the presence of a clustering of metabolic risk factors including presence of central obesity and a strong association with diabetes and cardiovascular diseases [1]. According to the International Diabetes Federation Consensus definition [2], for a person to be defined as having the metabolic syndrome, all of the following criteria must be met: Central obesity (defined as waist circumference more than ethnicity specific values; for Indian males C 90 cm & for Indian females C 80 cm; if BMI is [ 30 kg/m2, central obesity can be assumed and waist circumference does not need to be measured) Plus any two of the following four factors: 1) Raised triglycerides C 150 mg/dL (1.7 mmol/L) or specific treatment for this lipid abnormality 2) Reduced HDL cholesterol \ 40 mg/dL (1.03 mmol/L) in males & \ 50 mg/dL (1.29 mmol/L) in females or specific treatment for this lipi
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