RESUMO
INTRODUCTION: Central obesity is specifically associated with cardiovascular disease. Nevertheless, the molecular events that promote these conditions remain incompletely defined and risk stratifying patients for cardiovascular disease continues a challenge. OBJECTIVE: The aim of this study was to assess some cost-efficient haemostatic markers, and its association with central obesity and traditional cardiovascular risk factors, in a cohort of middle aged subjects, without clinical cardiovascular disease, as basis for an improved prevention and intervention. METHODS: We studied 307 men, aged 45±7 years, which underwent medical history, physical examination, anthropometric measurements, plasmatic biochemical parameters, plasma concentrations of fibrinogen, prothrombin activity, activated partial thromboplastin time, platelet count and mean platelet volume. RESULTS: Prothrombin activity values were significantly higher in patients with central obesity (103 ± 16 % vs 111 ± 17 %, p<0.001). Across tertiles of fibrinogen (low and high), there was an increase in cholesterol, adjusted for age and body mass index (4.9±0.9 mmol/L vs 5.4±1.1 mmol/L, p< 0.01). High tertile of prothrombin activity showed higher levels of cholesterol (4.8±1.0 mmol/L vs 5.4±0.9 mmol/L , p< 0.05), triglycerides (1.07±0.6 mmol/L vs 1.32±0.9 mmol/L, p< 0.05), and waist circumference (92.8±8.3 cm vs 96.5±8.8 cm, p= ns) . Mean values of cholesterol were higher in low-activated partial thromboplastin time tertile (5.3±0.9 mmol/L vs 4.9±1.1 mmol/L, p<0.01). Participants in the high-mean platelet volume tertile showed higher levels of glycemia (5.7±0.6 mmol/L vs 5.99±0.7 mmol/L, p<0.05). Significant positive correlations were observed between fibrinogen and cholesterol (r=0.198, p<0.001) and triglycerides (r=0.116, p<0.05). Prothrombin activity was positively correlated with waist circumference (r=0.156, p<0.05), glucose (r=0.227, p<0.001), cholesterol (r=0.270, p=0.001), triglycerides (r=0.187, p=0.001) and mean platelet volume (r=0.130, p=0.05). Activated partial thromboplastin time was inversely related cholesterol (r=-0.172, p<0.01) concentrations. Mean platelet volume rose with increasing glucose concentrations (r=0.170, p<0.01). CONCLUSIONS: Haemostatic markers studied have shown association with abdominal adiposity and established cardiovascular risk factors. These markers are widely available, relatively inexpensive, and might allow risk stratifying patients for cardiovascular disease and the identification of hypercoagulable state in patients who might deserve preventive measures and are potential tools for assessing the impact of these measures.
Introducción: La obesidad central está especialmente asociada con la enfermedad cardiovascular. No obstante, los mecanismos moleculares que la promueven no están completamente definidos y la estratificación del riesgo de los pacientes para la enfermedad cardiovascular sigue siendo un reto. Objetivo: Evaluar la asociación de la adiposidad central con marcadores hemostáticos coste-eficientes y con los factores de riesgo cardiovascular tradicionales en una cohorte de varones de mediana edad sin enfermedad cardiovascular clínica con objeto de mejorar la prevención y la intervención. Métodos: Estudiamos 307 varones de 45±7 años, a los que se realizó historia clínica, examen físico, mediciones antropométricas y determinaciones plasmáticas bioquímicas y de fibrinógeno, actividad protrombina, tiempo de tromboplastina parcial activada, recuento de plaquetas y volumen plaquetario medio. Resultados: Los valores de actividad protrombina fueron significativamente más elevados en pacientes con obesidad central (103 ± 16 % vs 111 ± 17 %, p.