Evaluation of the role of obesity and adipokines as risk factors of venous thromboembolism: a case-control study

• Grant number: 13/13804-0
• Support Opportunities: Regular Research Grants
• Start date: December 01, 2013
• End date: May 31, 2016
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Maria Stella Figueiredo
• Grantee: Maria Stella Figueiredo
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated researchers: Ana Clara Kneese Virgilio do Nascimento ; Ana Raimunda Dâmaso ; Carlos Sérgio Chiattone ; Fernanda Loureiro de Andrade Orsi ; Joyce Maria Annichino-Bizzacchi

Abstract

Venous thromboembolism (VTE) is a common disease in the general population associated with considerable morbidity and mortality. The understanding of VTE risk factors is an essential step for its prevention. The association between obesity and VTE is particularly important because of the increased prevalence of obesity worldwide. It is noteworthy that the pathophysiology of VTE in obesity is not fully clarified. Adipose tissue synthesizes some adipokines such as leptin, adiponectin and resistin that may influence hemostasis and inflammation. Nevertheless, literature is scarce or even absent about the role of those adipokines in VTE risk. The objective of this proposal is to investigate the effect of obesity and some adipokines (leptin, adiponectin, resistin, plasminogen activator inhibitor-1and proinflammatory cytokines) on VTE risk by comparing anthropometric measures of obesity and adipokines levels between VTE patients and controls. In cases and in controls, it will be investigated the correlation between adipokines levels and anthropometric measures of obesity, levels of coagulation factors that act as acute phase proteins and levels of markers of endothelial dysfunction, thrombin generation and fibrinolysis. As an extension of the goals of this project, we propose to assess the impact of metabolic syndrome and insulin resistance on thrombosis risk. This will be a case-control study, which will include patients of both sexes, aged between 18-60 years, and with a single VTE event. The inclusion will take place from 6 to 12 months after VTE and at least 1 month after the withdrawal of anticoagulation. The controls will be acquaintances or partners of patients without a history of VTE. Cases and controls will be sex- and age- matched. The estimated sample size will be 120 cases and 120 controls. It is expected that the results of the current proposal could provide notion for a better understanding of the pathophysiology of VTE in obesity, therefore contributing to the scientific basis of prospective cohorts and investigations aimed at evaluating the most effective measures for VTE prevention in obesity. (AU)