Dissociated effects of physical activity and weight loss on fibrinogen concentrations and markers of red blood cell aggregation. Relevance for life style modification in atherothrombosis
Affiliations: Nutrition and Diet Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel | Department of Internal Medicine “D”, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel | Physical Activity Center, Kfar Saba, Israel
Note: [] Corresponding author: Shlomo Berliner, MD, PhD, Head, Department of Internal Medicine D, Tel-Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel. Tel.: +972 3 6973313; Fax: +972 3 6974961; E-mail: shapiraiz@tasmc.health.gov.il.
Abstract: It has been shown that weight loss and physical activity contribute to a better biorheological profile. Yet, the concentrations of fibrinogen are not always reduced following life style modification. We evaluated the inter-relations between fibrinogen's pro red cell aggregation potential and reduced inflammation and improved lipid profile as anti-aggregating forces in a group of 20 apparently healthy obese volunteers following 4 and 8 months of intensive life modification program which included diet and strenuous physical activity. A significant (p=0.005) weight loss (from a mean±SD of 121.4±20.9 to 98.0±21.3 kg) and decrease in body mass index (from 40.8±4.3 to 32.9±5.3 kg/m2, p=0.005) was noted in fourteen individuals who completed the 8-month program. The concentrations of clottable fibrinogen rose from 318±96 to 387±72 mg/dl (p=0.012) while there was a significant reduction in the erythrocyte sedimentation rate (ESR) (from 19.0±12.6 to 10.8±7.5 mm/h, p=0.018), triglycerides (from 143±80 to 80±44 mg/dl, p=0.005), LDL cholesterol (from 128±34 to 103±17 mg/dl, p=0.005) and total cholesterol (from 211±40 to 171±17 mg/dl, p=0.007), as well as decrease in insulin concentration (from 36.1±21.3 to 20.6±8.0 μu/ml, p=0.01) and the insulin resistance index (HOMA-R, from 9.1±6.4 to 4.9±2.1 glu*ins/405, p=0.008). Despite a significant increment in the concentrations of clottable fibrinogen, a significant reduction was noted in the degree of red cell aggregation as measured by using a slide test and direct visualization of the aggregates. Our conclusion is that the pro-aggregating properties of fibrinogen following intense physical activity are probable counterbalanced by the anti-aggregatory properties of an improved lipid profile and an attenuated acute phase response.
Keywords: Fibrinogen, life style modification, erythrocyte aggregation, inflammation
