Abstract

SOSSA MELO, Claudia Lucía. Pro-thrombotic state and metabolic syndrome. Acta Med Colomb [online]. 2005, vol.30, n.3, pp.140-143. ISSN 0120-2448.

Obesity is associated with coagulation and fibrinolytic disorders, and visceral fat is a significant cardiovascular risk factor. Adipocytes are now known to play an active role in the characteristic reactions of insulin resistance, and several substances produced by adipocytes have been identified, such as the plasminogen-activation inhibitor (PAI-1), which is the most important fibrinolysis regulator and is found to be elevated in patients with metabolic syndrome, leading to reduced fibrinolysis and increased thrombin formation. Platelet function is also altered, with increased platelet aggregation and increased thrombin generation. The exact mechanism by which the pro-thrombotic state promotes the development of atherosclerosis or contributes to the development of acute cardiovascular events is yet unknown, but it has been suggested that it may be the result of endothelial dysfunction. The thrombosis that occurs in the atheromatous plaque is a key element in determining the severity of the disease. An interesting hypothesis suggests that plaque disruption is frequent, but it is only when there are large thrombi resulting from an imbalance between physiologic pro-coagulant and anti-coagulant factors that there is an acute coronary syndrome.

Keywords : visceral fat; platelet hyper-reactivity; fibrinogen; von Willebrand factor; plasminogen-activation inhibitor (IAP-1).