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Effect of Bariatric Surgery on Fibrinolysis Process in Morbidly Obese Patients

Iza Iwan-Ziętek, Małgorzata Michalska, Krzysztof Góralczyk, Barbara Ruszkowska-Ciastek, Stanisław Dąbrowiecki, Zbigniew Ziętek, Danuta Rość

(Division of Aesthetic Dermatology, Pomeranian Medical University in Szczecin, Szczecin, Poland)

Med Sci Tech 2017; 58:91-97

DOI: 10.12659/MST.905852

BACKGROUND: Fibrinolysis still remains an unexplored area in patients with morbid obesity. The aim of this study was to explore the fibrinolytic process in the blood of patients with morbid obesity who underwent bariatric surgery.
MATERIAL AND METHODS: The study involved 38 patients with morbid obesity who underwent bariatric surgery. All patients had undergone LAGB (Laparoscopic Adjustable Gastric Banding). The control group consisted of 20 healthy volunteers. The following parameters were measured: plasminogen activator inhibitor-1 antigen (PAI-1-Ag), tissue plasminogen activator antigen (t-PA-Ag), D-dimer, and plasminogen and α2-antiplasmin (α2-AP).
RESULTS: Before the operation, significantly higher levels of t-PA-Ag and PAI-1-Ag and higher α2-AP activity were observed. Plasminogen and D-dimers were similar as in the controls. Postoperatively, significantly increased D-dimers with decrease of α2-antiplasmin was observed. t-PA: Ag, PAI-1: Ag, and plasminogen did not differ significantly in comparison with before. The operation was successful in reducing BMI, which was significantly reduced by an average of about 5–10 kg within 1 month after surgery (p<0.0001).
CONCLUSIONS: The reduction of body weight coincided with increased levels of D-dimer and decreased α2-antiplasmin activity, showing activation of fibrinolysis in blood plasma of patients with morbid obesity. The preoperatively higher α2-antiplasmin activity in comparison with controls is difficult to explain, but as an acute-phase protein, it can reflect the chronic inflammatory process in morbid obesity.

Keywords: Bariatric Surgery, Body Mass Index, Fibrinolysis, Obesity, Morbid

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