Mechanisms of thrombosis in obesity

Ilya O Blokhin; Steven R Lentz

doi:10.1097/MOH.0b013e3283634443

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Journal article

Mechanisms of thrombosis in obesity

Ilya O Blokhin and Steven R Lentz

Current opinion in hematology, Vol.20(5), pp.437-444

09/2013

DOI: 10.1097/MOH.0b013e3283634443

PMCID: PMC4445633

PMID: 23817170

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Abstract

Obesity has become a worldwide epidemic that is driving increased morbidity and mortality from thrombotic disorders such as myocardial infarction, stroke, and venous thromboembolism. Effective prevention and treatment of thrombosis in obese patients is limited by an incomplete understanding of the underlying prothrombotic mechanisms and by uncertainties about risks, benefits, and dosing of anticoagulant drugs in this patient population. This review summarizes our current understanding of established and emerging mechanisms contributing to the obesity-induced prothrombotic state. The mechanistic impact of chronic inflammation and impaired fibrinolysis in mediating obesity-associated thrombosis is highlighted. Recent data demonstrating the aberrant expression of adipokines and microRNAs, which appear to function as key modulators of proinflammatory and prothrombotic pathways in obesity, are also reviewed. Finally, some challenges and new approaches to the prevention and management of thrombotic disorders in obese and overweight patients are discussed. Obesity-driven chronic inflammation and impaired fibrinolysis appear to be major effector mechanisms of thrombosis in obesity. The proinflammatory and hypofibrinolytic effects of obesity may be exacerbated by dysregulated expression and secretion of adipokines and microRNAs, which further increase the risk of thrombosis and suggest new potential targets for therapy.

Adipose Tissue - metabolism

Obesity - complications

Thrombosis - etiology

Humans

Anticoagulants - therapeutic use

Thrombosis - drug therapy

Fibrinolysis - physiology

Thrombosis - blood

Platelet Aggregation Inhibitors - therapeutic use

Obesity - blood

Adipokines - blood

Details

Title: Subtitle: Mechanisms of thrombosis in obesity
Creators: Ilya O Blokhin - Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242, USA
Steven R Lentz
Resource Type: Journal article
Publication Details: Current opinion in hematology, Vol.20(5), pp.437-444
DOI: 10.1097/MOH.0b013e3283634443
PMID: 23817170
PMCID: PMC4445633
NLM abbreviation: Curr Opin Hematol
ISSN: 1065-6251
eISSN: 1531-7048
Grant note: HL063943 / NHLBI NIH HHS R01 HL063943 / NHLBI NIH HHS P01 HL062984 / NHLBI NIH HHS HL062984 / NHLBI NIH HHS
Language: English
Date published: 09/2013
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984094383802771

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