Role of adipose tissue in haemostasis, coagulation and fibrinolysis
Article first published online: 12 MAY 2009
© 2009 The Authors. Journal compilation © 2009 International Association for the Study of Obesity
Volume 10, Issue 5, pages 554–563, September 2009
How to Cite
Faber, D. R., De Groot, Ph. G. and Visseren, F. L. J. (2009), Role of adipose tissue in haemostasis, coagulation and fibrinolysis. Obesity Reviews, 10: 554–563. doi: 10.1111/j.1467-789X.2009.00593.x
- Issue published online: 26 AUG 2009
- Article first published online: 12 MAY 2009
- Received 9 January 2009; accepted 2 March 2009; revised 26 February 2009
- Adipose tissue;
Obesity is associated with an increased incidence of insulin resistance (IR), type 2 diabetes mellitus and cardiovascular diseases. The increased risk for cardiovascular diseases could partly be caused by a prothrombotic state that exists because of abdominal obesity.
Adipose tissue induces thrombocyte activation by the production of adipose tissue-derived hormones, often called adipokines, of which some such as leptin and adiponectin have been shown to directly interfere with platelet function. Increased adipose tissue mass induces IR and systemic low-grade inflammation, also affecting platelet function. It has been demonstrated that adipose tissue directly impairs fibrinolysis by the production of plasminogen activator inhibitor-1 and possibly thrombin-activatable fibrinolysis inhibitor. Adipose tissue may contribute to enhanced coagulation by direct tissue factor production, but hypercoagulability is likely to be primarily caused by affecting hepatic synthesis of the coagulation factors fibrinogen, factor VII, factor VIII and tissue factor, by releasing free fatty acids and pro-inflammatory cytokines (tumour necrosis factor-α, interleukin-1β and interleukin-6) into the portal circulation and by inducing hepatic IR.
Adipose tissue dysfunction could thus play a causal role in the prothrombotic state observed in obesity, by directly and indirectly affecting haemostasis, coagulation and fibrinolysis.