اسم المؤلف:
هاله عبد الصمد جابر
اسم المشرف:
جعفر نوري جعفر ال السيد عيسى
المستخلص:
Obesity is a medical condition in which excess body fat has accumulated to the extent that it has an adverse effect on health. The normal BMI is 18.5 - 24.9 kg/m2 while obesity is considered when the BMI is ≥ 30.0 kg/m2. Obesity is an independent risk factor for venous thromboembolism. It increases the risk of thrombosis by two - fold. It increase the risk of many diseases including coronary heart disease, diabetes mellitus and cancer. Obesity are associated with elevated plasma levels of certain coagulation factors, such as fibrinogen, von Willebrand factor, and factor VII,VIII and XII .Chronic inflammation and impaired fibrinolysis in obesity may induce thrombosis. Adipose tissue is not an organ for fat storage only, it is also an active organ that secrete bioactive substance called adipokines, with prothrombotic or antithrombotic properties like leptin and adiponectin.Aim of study : • This study aims to assess the effects of BMI on plasma level of factorV andfibrinogen in obese and normal weight persons.Patient, materials and methodsThis cross sectional study included 76 subjects divided into51 obese with BMI≥30 kg /m2 and 25 control with BMI less than 25 kg /m2 who attended ALYarmok Teaching Hospital. Their age ranged from 18 to 50 years and having nohistory of (previous thrombosis, malignancy, surgical operation during the last 6months before and no drug therapy (non - steroidal anti - inflammatory drugs andhormonal therapy).Data collected from each participant included; name, age, medical history(hypertension, diabetes, rheumatoid arthritis, previous thrombosis), the time forthe last surgical procedure (if present), drug history, smoking history, recenttrauma, prolonged air travel, features of pulmonary embolism (shortness ofIIAbstractbreath, cough with bloody mucus, chest pain, fainting spells, dizziness), andfeatures of deep venous thrombosis (redness, warmth, tenderness, and swellingof the leg). Weight and height were measured, and then the BMI was calculatedfor each subjects.By a clean aseptic venipuncture 4.3 ml of blood were drawn from each patient and control. The sample was then divided between two tubes : • 2.5 ml of blood in dipotassium ethylene diamine tetra - acetic acid tube for platelet count which were performed using automated analyzer.• 1.8 ml of blood in disposable capped plastic tube containing 0.2 ml of 109 mmol/l trisodium citrate dihydrate (32 g/l) for coagulation study.Platelets poor plasmas were obtained by centrifugation of blood with 2000 g for 15 minutes, then 0.4 ml of plasma obtained from the upper part of the separated plasma was used for immediate measurement of prothrombin time, activated partial thromboplastin time, and for factor V assay and fibrinogen within 2 hours of blood collection using semi - automated coagulometer.Results : There were insignificant difference in mean prothrombin time, activated partial thromboplastin time, factor activity and platelet count of obese group compared to control group with (P > 0.05). There was significant difference in mean fibrinogen of obese compared to control with (P = 0.006). The correlation between body mass index and prothrombine time, platelet count, factor V and fibrinogen in obese and control study groups were statistically insignificant with (P > 0.05), but a significant positive correlation between body mass index and activated partial thrompoplastine in obese group was found (P=0.037). There was a high significant negative correlation between factor V and prothrombin time in obese and control groups (P =0.001). There was an insignificant positive correlation between fibrinogen and prothrombin time in obese and control groups (P > 0.05).Conclusions : 1. There is higher significant fibrinogen concentration in obese group when compared with normal weight group was found.2. There is insignificant difference in PT, aPTT, platelet count, FV activity between obese group and normal weight group.
