Elevated levels of fibrinogen in metabolically obese normal-weight subjects: A cross-sectional analysis of a sample of Peruvian inhabitants
Fibrinogen levels in metabolically obese normal-weightsubjects
DOI:
https://doi.org/10.14306/renhyd.26.4.1724%20Keywords:
Fibrinogen, obesity, metabolism, inflammationAbstract
Introduction: Plasmatic fibrinogen is known as a main risk factor to cardiometabolic diseases through mechanisms such as thrombin formation, platelet aggregation and inflammation, part of the endothelial dysfunction leading to Acute Coronary Syndrome. Elevated fibrinogen levels may be present in subjects with obesity; however, there is no enough information on whether this is also the same among metabolically obese normal-weight subjects (MONW).
Objective: To determine the association between being MONW and fibrinogen levels in a sample of Peruvian inhabitants.
Methodology: Cross-sectional analytical study. Secondary data analysis of the PERU MIGRANT study (2007, 989 participants). For the diagnosis of MONW, it was considered if it presented two or more characteristics such as: waist circumference (anthropometric evaluation), triglycerides, fasting glucose, systolic blood pressure or diastolic blood pressure, HDL-cholesterol, insulin resistance through HOMA-IR, C-reactive protein. Elevated fibrinogen ≥ 450 mg/dl was considered. For regression analysis we used generalized linear model with link log and family Poisson with robust variance. We present crude prevalence ratio and adjusted by mentioned variables, as association parameter. We considered confidence interval 95%.
Results: Of the 393 selected participants, 46.3% were women, the median of age was 47(37-56), only 13.5% had elevated fibrinogen levels. The prevalence of the MONW subject was 32.67%. In the correlation analysis, there was only a statistically significant relationship between fibrinogen and plasma CRP (rho= 0.54; p<0.001). In multiple regression, association was found between being MONW and high plasma fibrinogen levels (PR=1.93, 95% CI: 1.44-2.57; p<0.001).
Conclusion: There is an association between high levels of plasmatic fibrinogen and MONW. These results can serve as a first step for future prospective research, either to be a risk factor or as an additional marker of consideration for monitoring and diagnosis in normal-weight people.
References
REFERENCIAS
Obesidad y sobrepeso [Internet]. [citado el 1 de diciembre de 2021]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/obesity-and-overweight
Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019;15(5):288–98. doi:10.1038/s41574-019-0176-8
Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98–107. doi:10.1016/j.metabol.2018.10.011
Schulze MB. Metabolic health in normal-weight and obese individuals. Diabetologia. 2019;62(4):558–66. doi:10.1007/s00125-018-4787-8
Wang B, Zhuang R, Luo X, Yin L, Pang C, Feng T, et al. Prevalence of Metabolically Healthy Obese and Metabolically Obese but Normal Weight in Adults Worldwide: A Meta-Analysis. Horm Metab Res Horm Stoffwechselforschung Horm Metab. 2015;47(11):839–45. doi:10.1055/s-0035-1559767
Benziger CP, Bernabé-Ortiz A, Gilman RH, Checkley W, Smeeth L, Málaga G, et al. Metabolic Abnormalities Are Common among South American Hispanics Subjects with Normal Weight or Excess Body Weight: The CRONICAS Cohort Study. PLoS ONE. 2015;10(11). doi:10.1371/journal.pone.0138968
Ding C, Chan Z, Chooi YC, Choo J, Sadananthan SA, Chang A, et al. Regulation of glucose metabolism in nondiabetic, metabolically obese normal-weight Asians. Am J Physiol Endocrinol Metab. 2018;314(5):E494–502. doi:10.1152/ajpendo.00382.2017
Kapoor N, Furler J, Paul TV, Thomas N, Oldenburg B. Normal Weight Obesity: An Underrecognized Problem in Individuals of South Asian Descent. Clin Ther. 2019;41(8):1638–42. doi:10.1016/j.clinthera.2019.05.016
Stefan N. Metabolically Healthy and Unhealthy Normal Weight and Obesity. Endocrinol Metab Seoul Korea. 2020;35(3):487–93. doi:10.3803/EnM.2020.301
Karczewski J, Śledzińska E, Baturo A, Jończyk I, Maleszko A, Samborski P, et al. Obesity and inflammation. Eur Cytokine Netw. 2018;29(3):83–94. doi:10.1684/ecn.2018.0415
Luyendyk JP, Schoenecker JG, Flick MJ. The multifaceted role of fibrinogen in tissue injury and inflammation. Blood. 2019;133(6):511–20. doi:10.1182/blood-2018-07-818211
Chen S, Huang X, Huang Y, Zhao W, Zheng S, Huang Q, et al. Role of plasma fibrinogen in assessing disease activity of patients with gout. Clin Chim Acta Int J Clin Chem. 2020;510:483–7. doi:10.1016/j.cca.2020.08.012
Tao L, ShiChuan W, DeTai Z, Lihua H. Evaluation of lipoprotein-associated phospholipase A2, serum amyloid A, and fibrinogen as diagnostic biomarkers for patients with acute cerebral infarction. J Clin Lab Anal. 2020;34(3):e23084. doi:10.1002/jcla.23084
Peycheva M, Deneva T, Zahariev Z. The role of fibrinogen in acute ischaemic stroke. Neurol Neurochir Pol. 2021;55(1):74–80. doi:10.5603/PJNNS.a2020.0094
Aziz CBA, Omar N, Abdullah WZ, Jalil RA, Nik WSW, Zakaria R. Reduced Fibrinogen, Fibrinolytic Biomarkers, and Physical Parameters after a Weight-Loss Program in Obese Subjects. North Am J Med Sci. 2014;6(8):377–82. doi:10.4103/1947-2714.139286
Osadnik T, Bujak K, Osadnik K, Czarnecka H, Pawlas N, Reguła R, et al. Novel inflammatory biomarkers may reflect subclinical inflammation in young healthy adults with obesity. Endokrynol Pol. 2019;70(2):135–42. doi:10.5603/EP.a2019.0002
Bo M, Raspo S, Morra F, Cassader M, Isaia G, Poli L. Body fat is the main predictor of fibrinogen levels in healthy non-obese men. Metabolism. 2004;53(8):984–8. doi:10.1016/j.metabol.2003.12.009
Peppa M, Koliaki C, Papaefstathiou A, Garoflos E, Katsilambros N, Raptis SA, et al. Body composition determinants of metabolic phenotypes of obesity in nonobese and obese postmenopausal women. Obesity. 2013;21(9):1807–14. doi:10.1002/oby.20227
PERU MIGRANT Study | Baseline dataset [Internet]. figshare; 2016 [citado el 14 de marzo de 2021]. doi:10.6084/m9.figshare.3125005.v1
Miranda JJ, Gilman RH, García HH, Smeeth L. The effect on cardiovascular risk factors of migration from rural to urban areas in Peru: PERU MIGRANT Study. BMC Cardiovasc Disord. 2009;9:23. doi:10.1186/1471-2261-9-23
Levy JH, Goodnough LT. How I use fibrinogen replacement therapy in acquired bleeding. Blood. 2015;125(9):1387–93. doi:10.1182/blood-2014-08-552000
Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019;92:6–10. doi:10.1016/j.metabol.2018.09.005
Chen Q-F, Cao D, Ye T-T, Deng H-H, Zhu H. Peripheral Arterial Disease in Type 2 Diabetes Is Associated with an Increase in Fibrinogen Levels. Int J Endocrinol. 2018;2018:3709534. doi:10.1155/2018/3709534
Zhang J, Wang Y, Zhang R, Li H, Han Q, Wu Y, et al. Serum fibrinogen predicts diabetic ESRD in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2018;141:1–9. doi:10.1016/j.diabres.2018.04.025
Thorand B, Baumert J, Döring A, Herder C, Kolb H, Rathmann W, et al. Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis. 2006;184(1):216–24. doi:10.1016/j.atherosclerosis.2005.04.011
Montilla M, Santi MJ, Carrozas MA, Ruiz FA. Biomarcadores de estado protrombótico en la obesidad abdominal. Nutr Hosp. 2015;31(3):1059–66. doi:10.3305/nh.2015.31.3.8168
Zang R, Zhang H, Xu Y, Zhang S, Liu X, Wang J, et al. Serum C-reactive protein, fibrinogen and D-dimer in patients with progressive cerebral infarction. Transl Neurosci. 2016;7(1):84–8. doi:10.1515/tnsci-2016-0013
Ding C, Chan Z, Magkos F. Lean, but not healthy: the “metabolically obese, normal-weight” phenotype. Curr Opin Clin Nutr Metab Care. 2016;19(6):408–17. doi:10.1097/MCO.0000000000000317
Asghar A, Sheikh N. Role of immune cells in obesity induced low grade inflammation and insulin resistance. Cell Immunol. 2017;315:18–26. doi:10.1016/j.cellimm.2017.03.001
Alam I, Ng TP, Larbi A. Does inflammation determine whether obesity is metabolically healthy or unhealthy? The aging perspective. Mediators Inflamm. 2012;2012:456456. doi:10.1155/2012/456456
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Copyright (c) 2020 Victor Juan Vera-Ponce, Gianella Zulema Zeñas-Trujillo, Jenny Raquel Torres-Malca, Liliana Cruz-Ausejo, Mario J. Valladares-Garrido, Jesus Enrique Talavera Ramirez, Jose M Vela-Ruiz, Jhony A. De la Cruz Vargas
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