Abstract
The aim of this study was to evaluate hemostatic variables in women according to different body mass index (BMI) values ,and then correlate them with some metabolic parameters - fasting insulin and glucose, total cholesterol ,high-density lipoprotein (HDL)-cholesterol ,low-density lipoprotein (LDL)-cholesterol and triglycerides. Eighty-four female patients aged 18-39 years were recruited ,and agreed to participate in the study. The study group was divided into three subgroups according to BMI: low BMI (BMI < 18.5 kg/m2; n = 43) ,normal-weight (control) (BMI 18.5-24.99 kg/m2; n = 21) and overweight/obese (BMI > 25 kg/m2; n = 20). BMI was calculated ,and the following measurements were taken: International Normalized Ratio ,antithrombin III ,tissue plasminogen activator (t-PA) activity ,t-PA-antigen, plasma fibrinogen level ,factor VII ,Plasminogen activator inhibitor (PAI)-1 activity and antigen and metabolic parameters: fasting insulin and glucose ,total cholesterol ,HDL-cholesterol ,LDL-cholesterol and triglycerides. The results were statistically analyzed. In the low BMI group ,a negative correlation between fasting insulin and PAI-1 activity ,and a positive correlation between fasting glucose and PAI-1 antigen were observed. Also ,a strong negative correlation between PAI-1 activity and insulin/glucose index was found. Plasma insulin levels were significantly lower in the low-BMI women than in the overweight/obese group (p < 0.001) and with no difference compared to the control group. We did not find any difference in fasting glucose level between all groups. HDL-cholesterol showed the highest levels in the normal BMI group and was significantly higher than in the low BMI and obese groups (p < 0.05 and p < 0.01 ,respectively). PAI-1 activity in the low BMI women revealed increased activity in comparison to control and overweight/obese women (p < 0.001 and p < 0.05 ,respectively). Lower antigen levels were also shown as compared to both these groups (p < 0.001 and p < 0.001 ,respectively). Similar results were obtained with t-PA antigen levels (p < 0.001 and p < 0.001 ,respectively). There were no differences in activity of t-PA in all groups. Obese women showed significantly higher fibrinogen levels than other BMI groups (p < 0.001 and p < 0.001 respectively). Analysis of hemostatic variables in women with a low BMI testify to the impaired fibrinolysis in this group ,also showing a strong correlation with carbohydrate metabolism.