PROLONGED VERY-LOW-CALORIE DIET IN OBESE SUBJECTS REDUCES FACTOR-VII AND PAI BUT NOT FIBRINOGEN LEVELS

Fibrinogen, factor VII and plasminogen activator inhibitor (PAI) are now considered hematologic risk factors for cardiovascular disease and it is well known that their levels are increased in obesity. 52 obese healthy subjects (31 women), with BMI>30, were investigated to assess: (a) fibrinogen, factor VII and PAI levels in relation to the different types of body fat distribution, and (b) the effect of a prolonged period (3 months) of very low calorie diet (VLCD, 514 and 470 Kcal/day in women and men respectively) on the above mentioned variables. Only significantly higher factor VII and insulin levels were found in the subjects with the highest waist/hip ratio (WHR) values and no significant correlations were found between test results and WHR levels. After 3 months VLCD, body weight and BMI decreased markedly, and factor VII and PAI levels dropped significantly in 32/34 individuals who were compliant with the diet; changes in factor VII and PAI were correlated with decreases in BMI and apolipoprotein Al, but not with changes in insulin values or their sum after glucose load. Fibrinogen did not change significantly after diet. In conclusion, the present study in a group of highly obese subjects shows that a severe dietary restriction associated with marked weight loss consistently lowers factor VII and PAI, but not fibrinogen.