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- Title
Lifestyle Intervention Improves Prothrombotic Coagulation Profile in Individuals at High Risk for Type 2 Diabetes.
- Authors
Hörber, Sebastian; Lehmann, Rainer; Fritsche, Louise; Machann, Jürgen; Birkenfeld, Andreas L.; Häring, Hans-Ulrich; Stefan, Norbert; Heni, Martin; Fritsche, Andreas; Peter, Andreas
- Abstract
<bold>Context: </bold>Patients with obesity and insulin resistance are at higher risk for arterial and venous thrombosis due to a prothrombotic state.<bold>Objective: </bold>The present study addressed whether this is reversible by lifestyle intervention and elucidated potential underlying associations.<bold>Methods: </bold>A total of 100 individuals with impaired glucose tolerance or impaired fasting plasma glucose participated in a 1-year lifestyle intervention, including precise metabolic phenotyping and MRS-based determination of liver fat content as well as a comprehensive analysis of coagulation parameters before and after this intervention.<bold>Results: </bold>During the lifestyle intervention, significant reductions in coagulation factor activities (II, VII, VIII, IX, XI, and XII) were observed. Accordingly, prothrombin time (PT%) and activated partial thromboplastin time (aPTT) were slightly decreased and prolonged, respectively. Moreover, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF), and also protein C and protein S decreased. Fibrinogen, antithrombin, D-dimer, and FXIII remained unchanged. Searching for potential regulators, especially weight loss, but also liver fat reduction, improved insulin sensitivity, and decreased low-grade inflammation were linked to favorable changes in hemostasis parameters. Independent of weight loss, liver fat reduction (FII, protein C, protein S, PAI-1, vWF), improved insulin sensitivity (protein S, PAI-1), and reduced low-grade inflammation (PT%, aPTT, FVIII/IX/XI/XII, vWF) were identified as single potential regulators.<bold>Conclusion: </bold>Lifestyle intervention is able to improve a prothrombotic state in individuals at high risk for type 2 diabetes. Besides body weight, liver fat content, insulin sensitivity, and systemic low-grade inflammation are potential mechanisms for improvements in hemostasis and could represent future therapeutic targets.
- Subjects
TYPE 2 diabetes; BLOOD coagulation; LIFESTYLES; OBESITY; GLUCOSE intolerance; THROMBOSIS; PROTHROMBIN time; RESEARCH; LIVER; RESEARCH methodology; NUCLEAR magnetic resonance spectroscopy; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; RESEARCH funding; INSULIN resistance; ADIPOSE tissues
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 8, pe3198
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgab124