Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 4, July-August, p. 755–761

doi: 10.17219/acem/42414

Publication type: original article

Language: English

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Effect of a 3-Week Low-Calorie Diet and Balneological Treatment on Selected Coagulation Parameters in Morbidly Obese Patients

Agnieszka Firszt-Adamczyk1,A,B,C, Barbara Ruszkowska-Ciastek1,D,E, Przemysław Adamczyk1,B,C, Robert Szafkowski2,B, Mirosława Firszt3,C, Irena Ponikowska2,E, Kristoffer Moe1,C, Iza Iwan-Ziętek4,E, Barbara Góralczyk1,B, Krzysztof Góralczyk1,C, Danuta Rość1,F

1 Department of Pathophysiology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland

2 Clinic of Balneology and Physical Medicine, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland

3 Faculty of Mathematics and Computer Science, Nicolaus Copernicus University in Toruń, Poland

4 Department of Dermatology and Venerology, Pomeranian Medical University, Szczecin, Poland


Background. The most common cause of death among people with obesity are cardiovascular complications as a result of a hypercoagulability state.
Objectives. The purpose of the study was to assess the potential of coagulation system activation depending on the tissue factor and to analyze of the influence of a 3-week low-calorie diet and balneological treatment on selected coagulation parameters in morbidly obese patients.
Material and Methods. The study included 36 patients (28 females and 8 males; mean age 46) with the value of BMI > 40 kg/m2. The study was designed in two stages: baseline and after 21-days. The evaluation of tissue factor (TF), tissue factor pathway inhibitor (TFPI), von Willebrand factor (vWF), fibrinogen, D-dimer, thrombin-antithrombin complexes (TAT), and the activity of antithrombin (AT) was performed in patients before and after the treatment. The control group consisted of 24 healthy volunteers (16 females and 8 males) at a mean age of 39 with BMI . 24.9 kg/m2.
Results. There were significantly higher levels of TF, TFPI, fibrinogen, TAT complexes and D-dimer in the study group as compared to the controls. Moreover, there were no significant changes in the parameters studied before and after the treatment. In the group of obese patients, there were significant positive correlations between the concentrations of vWF and BMI and BMI changes and a significant negative correlation between the WHR changes and TFPI concentration.
Conclusion. The study confirmed that morbidly obese patients represent a high risk of hypercoagulability state, despite no clinical evidence, which could be due to the great inhibitory potential of TFPI in suppressing the extrinsic pathway of the coagulation system. However, the lack of effect of the 3-week exposure to the LCD and balneological treatment in morbidly obese subjects indicates that substantial fat mass must be reduced before adequate hemostasis is re-established.

Key words

morbid obesity, low-calorie diet, balneotherapy, tissue factor, tissue factor pathway inhibitor

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