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Hörber, S. ; Lehmann, R. ; Fritsche, L. ; Machann, J. ; Birkenfeld, A.L. ; Häring, H.-U. ; Stefan, N. ; Heni, M. ; Fritsche, A. ; Peter, A.

Lifestyle intervention improves prothrombotic coagulation profile in individuals at high-risk for type 2 diabetes.

J. Clin. Endocrinol. Metab. 106, E3198-E3207 (2021)
Publ. Version/Full Text Postprint DOI PMC
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AIMS: Patients with obesity and insulin resistance are at higher risk for arterial and venous thrombosis due to a prothrombotic state. If this is reversible by lifestyle intervention was addressed in the current study and potential underlying associations were elucidated. SUBJECTS AND METHODS: One-hundred individuals with impaired glucose tolerance or impaired fasting plasma glucose participated in a 1-year lifestyle intervention, including precise metabolic phenotyping and MRT-based determination of liver fat content as well as a comprehensive analysis of coagulation parameters before and after this intervention. RESULTS: 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, PAI-1, 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. CONCLUSIONS: 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.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Prediabetes ; Fibrinolysis ; Hemostasis ; Lifestyle Intervention ; Thrombosis; Plasminogen-activator Inhibitor-1; Impaired Glucose-tolerance; Fatty Liver-disease; Plasma Pai-1 Levels; Adipose-tissue; Insulin-resistance; Venous Thromboembolism; Weight-loss; Procoagulant Imbalance; Improved Fibrinolysis
ISSN (print) / ISBN 0021-972X
e-ISSN 1945-7197
Journal Journal of Clinical Endocrinology & Metabolism, The
Quellenangaben Volume: 106, Issue: 8, Pages: E3198-E3207 Article Number: , Supplement: ,
Publisher Endocrine Society
Publishing Place Bethesda, Md.
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)
Grants German Center for Diabetes Research (DZD) - German Federal Ministry for Education and Research