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DOI: 10.1055/s-0031-1297369
Obesity and Venous Thrombosis: A Review
Publication History
Publication Date:
23 December 2011 (online)

ABSTRACT
The world is experiencing an obesity pandemic, with rates of obesity rising for more than two decades. Obesity is defined as a body mass index (BMI) of 30 kg/m2 or greater. Of particular concern are the risks that millions of obese people are likely to develop chronic diseases and at earlier ages than their parents might have. The risk of venous thrombosis increases with obesity, so that the incidence of this pathology is also expected to rise significantly. There is remarkable and consistent evidence from a systematic review, as well as cohort and case–control studies that obesity might predispose to venous thromboembolism (VTE). The risk appears to be at least double that for normal weight subjects (BMI 20 to 24.9 kg/m2). Plausible mechanisms exist to explain this relationship, including the physical effects of body fat limiting venous return and a proinflammatory, prothrombotic, and hypofibrinolytic milieu. Loss of body weight has been shown to reduce the concentrations of coagulation factors and plasminogen activator inhibitor-1 toward the normal range. Whether weight loss would prevent secondary occurrence of VTE in the absence of anticoagulant therapy could not be discerned from this literature search.
KEYWORDS
Obesity - thrombosis - venous thromboembolism
REFERENCES
- 1
Nejat E J, Polotsky A J, Pal L.
Predictors of chronic disease at midlife and beyond—the health risks of obesity.
Maturitas.
2010;
65
(2)
106-111
MissingFormLabel
- 2
Allman-Farinelli M A, Chey T, Bauman A E, Gill T, James W P.
Age, period and birth cohort effects on prevalence of overweight and obesity in Australian
adults from 1990 to 2000.
Eur J Clin Nutr.
2008;
62
(7)
898-907
MissingFormLabel
- 3
van Dam R M, Willett W C, Manson J E, Hu F B.
The relationship between overweight in adolescence and premature death in women.
Ann Intern Med.
2006;
145
(2)
91-97
MissingFormLabel
- 4
Aitken R J, Allman-Farinelli M A, King L A, Bauman A.
Current and future costs of cancer, heart disease and stroke attributable to obesity
in Australia—a comparison of two birth cohorts.
Asia Pac J Clin Nutr.
2009;
18
63-70
MissingFormLabel
- 5
Allman-Farinelli M A, Aitken R J, King L A, Bauman A E.
Osteoarthritis—the forgotten obesity-related epidemic with worse to come.
Med J Aust.
2008;
188
(5)
317
MissingFormLabel
- 6
Levin P D, Weissman C.
Obesity, metabolic syndrome, and the surgical patient.
Med Clin North Am.
2009;
93
(5)
1049-1063
MissingFormLabel
- 7
Nordström M, Lindblad B, Bergqvist D, Kjellström T.
A prospective study of the incidence of deep-vein thrombosis within a defined urban
population.
J Intern Med.
1992;
232
(2)
155-160
MissingFormLabel
- 8
Ageno W, Becattini C, Brighton T, Selby R, Kamphuisen P W.
Cardiovascular risk factors and venous thromboembolism: a meta-analysis.
Circulation.
2008;
117
(1)
93-102
MissingFormLabel
- 9
Di Minno G, Mannucci P M, Tufano A First Ambulatory Screening On Thromboembolism (fast) Study Group et al.
The first ambulatory screening on thromboembolism: a multicentre, cross-sectional,
observational study on risk factors for venous thromboembolism.
J Thromb Haemost.
2005;
3
(7)
1459-1466
[Multicenter Study]
MissingFormLabel
- 10
Samama M M.
An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients:
the Sirius study. Archives of Internal Medicine. [Research Support, Non-U.S. Govt].
2000 Dec 11–25;160(22):3415–20
MissingFormLabel
- 11
Cushman M.
Epidemiology and risk factors for venous thrombosis.
Semin Hematol.
2007;
44
(2)
62-69
MissingFormLabel
- 12
Hansson P O, Eriksson H, Welin L, Svärdsudd K, Wilhelmsen L.
Smoking and abdominal obesity: risk factors for venous thromboembolism among middle-aged
men: “the study of men born in 1913”.
Arch Intern Med.
1999;
159
(16)
1886-1890
MissingFormLabel
- 13
Romualdi E, Squizzato A, Ageno W.
Abdominal obesity and the risk of recurrent deep vein thrombosis.
Thromb Res.
2007;
119
(6)
687-690
MissingFormLabel
- 14
Eichinger S, Hron G, Bialonczyk C et al..
Overweight, obesity, and the risk of recurrent venous thromboembolism.
Arch Intern Med.
2008;
168
(15)
1678-1683
MissingFormLabel
- 15
Ageno W, Piantanida E, Dentali F et al..
Body mass index is associated with the development of the post-thrombotic syndrome.
Thromb Haemost.
2003;
89
(2)
305-309
MissingFormLabel
- 16
Darvall K A, Sam R C, Silverman S H, Bradbury A W, Adam D J.
Obesity and thrombosis.
Eur J Vasc Endovasc Surg.
2007;
33
(2)
223-233
[Review]
MissingFormLabel
- 17
Van Guilder G P, Hoetzer G L, Greiner J J, Stauffer B L, DeSouza C A.
Metabolic syndrome and endothelial fibrinolytic capacity in obese adults.
Am J Physiol Regul Integr Comp Physiol.
2008;
294
(1)
R39-R44
MissingFormLabel
- 18
Dellas C, Schäfer K, Rohm I et al..
Absence of leptin resistance in platelets from morbidly obese individuals may contribute
to the increased thrombosis risk in obesity.
Thromb Haemost.
2008;
100
(6)
1123-1129
MissingFormLabel
- 19
Chu N F, Spiegelman D, Hotamisligil G S, Rifai N, Stampfer M, Rimm E B.
Plasma insulin, leptin, and soluble TNF receptors levels in relation to obesity-related
atherogenic and thrombogenic cardiovascular disease risk factors among men.
Atherosclerosis.
2001;
157
(2)
495-503
MissingFormLabel
- 20
Singh P, Peterson T E, Barber K R et al..
Leptin upregulates the expression of plasminogen activator inhibitor-1 in human vascular
endothelial cells.
Biochem Biophys Res Commun.
2010;
392
(1)
47-52
MissingFormLabel
- 21
Juhan-Vague I, Alessi M C.
Regulation of fibrinolysis in the development of atherothrombosis: role of adipose
tissue.
Thromb Haemost.
1999;
82
(2)
832-836
[Review]
MissingFormLabel
- 22
Rosito G A, D'Agostino R B, Massaro J et al..
Association between obesity and a prothrombotic state: the Framingham Offspring Study.
Thromb Haemost.
2004;
91
(4)
683-689
MissingFormLabel
- 23
Alessi M C, Juhan-Vague I.
PAI-1 and the metabolic syndrome: links, causes, and consequences.
Arterioscler Thromb Vasc Biol.
2006;
26
2200-2207
MissingFormLabel
- 24
Steffen L M, Cushman M, Peacock J M et al..
Metabolic syndrome and risk of venous thromboembolism: Longitudinal Investigation
of Thromboembolism Etiology.
J Thromb Haemost.
2009;
7
(5)
746-751
MissingFormLabel
- 25
Reiner A P, Siscovick D S, Rosendaal F R.
Hemostatic risk factors and arterial thrombotic disease.
Thromb Haemost.
2001;
85
(4)
584-595
MissingFormLabel
- 26
Folsom A R, Qamhieh H T, Wing R R et al..
Impact of weight loss on plasminogen activator inhibitor (PAI-1), factor VII, and
other hemostatic factors in moderately overweight adults.
Arterioscler Thromb.
1993;
13
(2)
162-169
MissingFormLabel
- 27
Marckmann P, Toubro S, Astrup A.
Sustained improvement in blood lipids, coagulation, and fibrinolysis after major weight
loss in obese subjects.
Eur J Clin Nutr.
1998;
52
(5)
329-333
MissingFormLabel
- 28
Rissanen P, Vahtera E, Krusius T, Uusitupa M, Rissanen A.
Weight change and blood coagulability and fibrinolysis in healthy obese women.
Int J Obes Relat Metab Disord.
2001;
25
(2)
212-218
MissingFormLabel
- 29
Tsai A W, Cushman M, Rosamond W D, Heckbert S R, Polak J F, Folsom A R.
Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal
investigation of thromboembolism etiology.
Arch Intern Med.
2002;
162
(10)
1182-1189
MissingFormLabel
- 30
Ay C, Tengler T, Vormittag R et al..
Venous thromboembolism—a manifestation of the metabolic syndrome.
Haematologica.
2007;
92
(3)
374-380
MissingFormLabel
- 31
Lemkes B A, Hermanides J, Devries J H, Holleman F, Meijers JCM, Hoekstra JBL.
Hyperglycemia: a prothrombotic factor?.
J Thromb Haemost.
2010;
8
(8)
1663-1669
MissingFormLabel
- 32
Lindqvist P G, Epstein E, Olsson H.
The relationship between lifestyle factors and venous thromboembolism among women:
a report from the MISS study.
Br J Haematol.
2009;
144
(2)
234-240
MissingFormLabel
- 33
van Stralen K J, Doggen CJM, Lumley T et al..
The relationship between exercise and risk of venous thrombosis in elderly people.
J Am Geriatr Soc.
2008;
56
(3)
517-522
MissingFormLabel
- 34
Van Guilder G P, Hoetzer G L, Smith D T et al..
Endothelial t-P`A release is impaired in overweight and obese adults but can be improved
with regular aerobic exercise.
Am J Physiol Endocrinol Metab.
2005;
289
(5)
E807-E813
MissingFormLabel
- 35
Aguilera C M, Ramírez-Tortosa M C, Mesa M D, Gil A.
[Protective effect of monounsaturated and polyunsaturated fatty acids on the development
of cardiovascular disease].
Nutr Hosp.
2001;
16
(3)
78-91
MissingFormLabel
- 36
Brand-Miller J, Dickinson S, Barclay A, Allman-Farinelli M.
Glycemic index, glycemic load, and thrombogenesis.
Semin Thromb Hemost.
2009;
35
(1)
111-118
MissingFormLabel
- 37
Lutsey P L, Steffen L M, Virnig B A, Folsom A R.
Diet and incident venous thromboembolism: the Iowa Women's Health Study.
Am Heart J.
2009;
157
(6)
1081-1087
MissingFormLabel
- 38
Steffen L M, Folsom A R, Cushman M, Jacobs Jr D R, Rosamond W D.
Greater fish, fruit, and vegetable intakes are related to lower incidence of venous
thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology.
Circulation.
2007;
115
(2)
188-195
MissingFormLabel
Margaret A. Allman-FarinelliPh.D. M.Phil.P.H.
Associate Professor in Nutrition and Dietetics, School of Molecular Bioscience
University of Sydney, NSW 2006, Australia
Email: margaret.allmanfarinelli@sydney.edu.au