The Relationship Between Proinflammatory Cytokine Levels and Fibrinolytic System in Obese Patients

Objectives: The aim of this study was to investigate the relationship between proinflammatory cytokines (TNF-aalpha; and IL-6), and fibrinolytic system parameters (t-PA, and PAI-1) and insulin resistance in obese individuals. Patients and Methods: The study included 54 obese subjects (BMI age;30 kg/m2; 41 females, 13 males; mean age 33.5 years) and 30 non-obese healthy individuals (BMI alt;25 kg/m2; 19 females, 11 males; mean age 22.3 years). Fibrinogen levels were measured by the coagulometric method and the measurements of TNF-aalpha;, IL-6, t-PA and PAI-1 were carried out by the ELISA method. Results: Compared with non-obese subjects, obese individuals had significantly higher fibrinogen (palt;0.01), PAI-1 (palt;0.001), TNF-aalpha; (palt;0.01), and IL-6 (palt;0.001) levels, and significantly lower t-PA level (palt;0.001) and t-PA/PAI-1 ratio (palt;0.001). We also found an inverse relationship between TNF-aalpha; and t-PA levels (p=0.007) and t-PA/PAI-1 ratio (p=0.016) in obese individuals. The presence or absence of insulin resistance did not affect proinflammatory cytokines and fibrinolytic system parameters in obese individuals. Conclusion: Our findings indicate increased inflammatory cytokine levels especially in TNF-aalpha; level, and decreased fibrinolysis in obese individuals. These changes may contribute to atherosclerotic process independent from insulin resistance in obesity. Turkish Baslik: Obez Hastalarda Proinflamatuvar Sitokinler ile Fibrinolitik Sistem Arasindaki Iliski Anahtar Kelimeler: Sitokinler; fibrinoliz; insulin direnci; obezite/komplikasyon Amac: Obez kisilerde proinflamatuar sitokinlerden TNF-aalpha; ve IL-6, fibrinolitik sistem parametrelerinden t-PA ve PAI-1 ve insulin direnci arasindaki iliski arastirildi. Hastalar ve Yontemler: Calismaya obez (VKI age;30 kg/m2) olarak degerlendirilen 54 kisi (41 kadin, 13 erkek; ort. yas 33.5) ve obezite sorunu olmayan (VKI alt;25 kg/m2) 30 kisi (19 kadin, 11 erkek; ort. yas 22.3) alindi. Fibrinojen duzeyleri koagulometrik olarak ve TNF-aalpha;, IL-6, t-PA, PAI-1 duzeyleri ELISA yontemiyle olculdu. Bulgular: Kontrol grubuyla karsilastirildiginda, obez kisilerde fibrinojen (palt;0.01), PAI-1 (palt;0.001), TNF-aalpha; (palt;0.01) ve IL-6 duzeyleri (palt;0.001) anlamli derecede yuksek, t-PA duzeyi (palt;0.001) ve t-PA/PAI-1 orani (palt;0.001) anlamli derecede dusuk bulundu. Obezlerde TNF-aalpha; ile t-PA (p=0.007) ve t-PA/PAI-1 orani (p=0.016) arasinda ters iliski saptandi. Insulin direnci olan ve olmayan obez kisilerde parametreler arasinda fark yoktu. Sonuc: Obezitede adipoz dokudan salgilanan ozellikle TNF-aalpha; gibi inflamatuar sitokinlerin artmasi fibrinolizde azalmaya yol acar. Obez kisilerde gorulen bu degisiklikler, insulin direncinden bagimsiz olarak ateroskleroza neden olabilir.