To Study the Coagulation Profile Derangements in Metabolic Syndrome

Introduction: The metabolic syndrome is a complex disorder characterized by the presence of a clustering of metabolic risk factors usually in a single individual associated with the presence of central obesity and a strong association with diabetes and cardiovascular disease morbidity and mortality.

It is a fast spreading global pandemic & emerging as a public health problem with poor outcome and Quality of life thus more predilection is towards preventive than curative treatment.

According to WHO Clinical Criteria, Metabolic syndrome is defined as insulin resistance, identified by 1 of the following, Type 2 diabetes, fasting blood glucose more than 110 mg/dl plus any 2 of the following: antihypertensive medication and /or high blood pressure > 140 mm systolic or >90 mm diastolic, plasma triglyceride (TG) level more than 150 mg/dl (1.7 mmol/L), high-density lipoprotein (HDL) cholesterol level less than 35 mg/dl (0.9 mmol/L) in men or less than 39 (1.0 mmol/L)in women , BMI >30 kg/m² and/or waist:hip ratio >0.9 in men, > 0.85 in women, Urinary albumen excretion rate > 20 mcg/min or albumin:creatinine ratio>30mg/g

Aims & Objectives:

• To investigate the coagulation profile derangements in metabolic syndrome.

• To study the relationship of various components of metabolic syndrome with coagulation parameters.

Material & Methods:

This was a prospective cross-sectional study carried out in Haematology & Medicine Deptt of SafdarJang Hospital, New Delhi. After taking consent from the Hospital Ethics Committee, a total of 50 cases of metabolic syndrome presenting as outpatient or inpatient were included in the study. 50 age & sex matched controls were selected which did not satisfy the criteria for metabolic syndrome.

Observation & Results:

In our study we found that the cases with metabolic syndrome have significantly increased levels of Fibrinogen, Factor VIII and Plasminogen Activator Inhibitor1 (PAI1). PT & APTT were shorter in cases with metabolic syndrome.

The mean value of fibrinogen in cases was 402.24 ± 66.92 mg/dl while that in control was 261.5 ± 41.95 mg/dl with a P value of <.0001 which was statistically significant.

The mean value of Factor VIII in cases was 152.66 ± 7.54 IU/dl while that in control was 131.44 ± 6.24 IU/dl with a P value of <.0001 which was statistically significant.

The mean value of Plasminogen Activator Inhibitor1 (PAI1) in cases was 49.99 ± 5.34 ng/ml while that in control was 36.75 ± 3.35 ng/ml with a P value of <.0001 which was statistically significant.

Prothrombin Time (PT) values in cases were 9.79 ± 0.74 seconds and in controls were 12.04 ± 0.7 seconds & this difference was statistically significant (p<.0001).

Activated partial Thromboplastin Time (APTT) values in cases were 28.96 ± 0.92 seconds and in controls were 32.6 ± 1.34 seconds & this difference was statistically significant (p<.0001).

Conclusions:

The coagulation parameters studied correlated significantly with the components of metabolic syndrome. The values varied significantly with increased number of features of metabolic syndrome.

Thus we can conclude that metabolic syndrome is a hypercoagulable state and further studies are required for further evaluation of the consequences of this hypercoagulable state..