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Obesity Surgery
Published in: Obesity Surgery 2/2017

01-02-2017 | Original Contributions

Effect of Bariatric Surgery-Induced Weight Loss on Platelet Count and Mean Platelet Volume: a 12-Month Follow-Up Study

Authors: Loïc Raoux, David Moszkowicz, Karina Vychnevskaia, Tigran Poghosyan, Alain Beauchet, Sylvain Clauser, Marion Bretault, Sébastien Czernichow, Claire Carette, Jean-Luc Bouillot

Published in: Obesity Surgery | Issue 2/2017

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Abstract

Background

Abdominal obesity is strongly correlated with cardiovascular risk and associated with platelet hyperactivity. This hyperactivity is associated with an increase in mean platelet volume (MPV). Few data are available about changes in platelet counts and MPV in obese patients after bariatric surgery (BS). The purpose of this study was to describe quantitative and qualitative changes in the platelet lineage after BS.

Methods

One hundred twenty-eight consecutive patients were included. The mean age was 43 ± 12 years, 77 % of patients were female, and the mean preoperative BMI was 44 ± 6 kg/m2. Ninety patients (71 %) had a Roux-en-Y gastric bypass (RYGBP), and 38 (29 %) had a sleeve gastrectomy (SG). Patients were evaluated preoperatively, and postoperative follow-up was performed at 3, 6, and 12 months. The postoperative evaluation included blood samples for full blood count (FBC), including measure of mean platelet volume (MPV).

Results

At the 12-month follow-up, the reduction in preoperative weight was 29 ± 9 %. We showed a significant decrease in platelet count (245 ± 62 vs. 234 ± 54 G/L; p = 0.0015) found in parallel with a non-significant decrease in MPV (9.27 ± 1.1 vs. 9.22 ± 1.05; p = 0.34). With regard to the intervention type, SG caused a more significant decrease in platelet count than RYGBP (p = 0.02). There was no significant difference in MPV variations between the two groups (p = 0.08).

Conclusions

Our results suggest that BS has a positive impact on platelet metabolism, possibly mediated by weight loss. These data need to be confirmed to understand the multifactorial benefits of BS on cardiovascular risk in obese patients.
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Literature
1.
Després J-P. Cardiovascular disease under the influence of excess visceral fat. Crit Pathw Cardiol. 2007;6(2):51–9.CrossRefPubMed
2.
Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case–control study. Lancet Lond Engl. 2005;366(9497):1640–9.CrossRef
3.
Alberti KGMM, Zimmet P, Shaw J, IDF Epidemiology Task Force Consensus Group. The metabolic syndrome—a new worldwide definition. Lancet Lond Engl. 2005;366(9491):1059–62.CrossRef
4.
Stepanian A, Bourguignat L, Hennou S, Coupaye M, Hajage D, Salomon L, et al. Microparticle increase in severe obesity: not related to metabolic syndrome and unchanged after massive weight loss. Obes Silver Spring Md. 2013;21(11):2236–43.CrossRef
5.
Morange P-E, Alessi M-C. Thrombosis in central obesity and metabolic syndrome: mechanisms and epidemiology. Thromb Haemost. 2013;110(4):669–80.CrossRefPubMed
6.
Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol. 2002;117(2):399–404.CrossRefPubMed
7.
Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract. 2009;63(10):1509–15.CrossRefPubMed
8.
Anfossi G, Russo I, Doronzo G, Pomero A, Trovati M. Adipocytokines in atherothrombosis: focus on platelets and vascular smooth muscle cells. Mediators Inflamm. 2010;2010:174341.CrossRefPubMedPubMedCentral
9.
Coban E, Ozdogan M, Yazicioglu G, Akcit F. The mean platelet volume in patients with obesity. Int J Clin Pract. 2005;59(8):981–2.CrossRefPubMed
10.
Coban E, Yilmaz A, Sari R. The effect of weight loss on the mean platelet volume in obese patients. Platelets. 2007;18(3):212–6.CrossRefPubMed
11.
Toplak H, Sagmeister E, Wascher TC. Cardiovascular risk factors in obesity. The effect of weight reduction on platelet size in overweight patients. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1994;18(5):355–6.
12.
Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.CrossRefPubMed
13.
Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed
14.
15.
Dallal RM, Leighton J, Trang A. Analysis of leukopenia and anemia after gastric bypass surgery. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2012;8(2):164–8.CrossRef
16.
Troussard X, Vol S, Cornet E, Bardet V, Couaillac J-P, Fossat C, et al. Determination of full blood count normal reference values for adults in France. Ann Biol Clin (Paris). 2014;72(5):561–81.
17.
Ciangura C, Bouillot J-L, Lloret-Linares C, Poitou C, Veyrie N, Basdevant A, et al. Dynamics of change in total and regional body composition after gastric bypass in obese patients. Obes Silver Spring Md. 2010;18(4):760–5.CrossRef
18.
Brooks GC, Blaha MJ, Blumenthal RS. Relation of C-reactive protein to abdominal adiposity. Am J Cardiol. 2010;106(1):56–61.CrossRefPubMed
19.
Samocha-Bonet D, Justo D, Rogowski O, Saar N, Abu-Abeid S, Shenkerman G, et al. Platelet counts and platelet activation markers in obese subjects. Mediators Inflamm. 2008;2008:834153.CrossRefPubMedPubMedCentral
20.
Tymitz K, Engel A, McDonough S, Hendy MP, Kerlakian G. Changes in ghrelin levels following bariatric surgery: review of the literature. Obes Surg. 2011;21(1):125–30.CrossRefPubMed
21.
Elbatarny HS, Netherton SJ, Ovens JD, Ferguson AV, Maurice DH. Adiponectin, ghrelin, and leptin differentially influence human platelet and human vascular endothelial cell functions: implication in obesity-associated cardiovascular diseases. Eur J Pharmacol. 2007;558(1–3):7–13.CrossRefPubMed
22.
23.
Billeter AT, Senft J, Gotthardt D, Knefeli P, Nickel F, Schulte T, et al. Combined non-alcoholic fatty liver disease and type 2 diabetes mellitus: sleeve gastrectomy or gastric bypass?—a controlled matched pair study of 34 patients. Obes Surg. 2015.
24.
Adler BJ, Kaushansky K, Rubin CT. Obesity-driven disruption of haematopoiesis and the bone marrow niche. Nat Rev Endocrinol. 2014;10(12):737–48.CrossRefPubMed
25.
Guthikonda S, Alviar CL, Vaduganathan M, Arikan M, Tellez A, DeLao T, et al. Role of reticulated platelets and platelet size heterogeneity on platelet activity after dual antiplatelet therapy with aspirin and clopidogrel in patients with stable coronary artery disease. J Am Coll Cardiol. 2008;52(9):743–9.CrossRefPubMed
26.
Davì G, Guagnano MT, Ciabattoni G, Basili S, Falco A, Marinopiccoli M, et al. Platelet activation in obese women: role of inflammation and oxidant stress. JAMA. 2002;288(16):2008–14.CrossRefPubMed
27.
Benaiges D, Flores Le-Roux JA, Pedro-Botet J, Chillarón JJ, Renard M, Parri A, et al. Sleeve gastrectomy and Roux-en-Y gastric bypass are equally effective in correcting insulin resistance. Int J Surg Lond Engl. 2013;11(4):309–13.CrossRef
28.
Anfossi G, Russo I, Trovati M. Platelet dysfunction in central obesity. Nutr Metab Cardiovasc Dis NMCD. 2009;19(6):440–9.CrossRefPubMed
29.
Falcon C, Pfliegler G, Deckmyn H, Vermylen J. The platelet insulin receptor: detection, partial characterization, and search for a function. Biochem Biophys Res Commun. 1988;157(3):1190–6.CrossRefPubMed
30.
Anfossi G, Russo I, Trovati M. Platelet resistance to the anti-aggregating agents in the insulin resistant states. Curr Diabetes Rev. 2006;2(4):409–30.CrossRefPubMed
31.
Woelnerhanssen B, Peterli R, Steinert RE, Peters T, Borbély Y, Beglinger C. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2011;7(5):561–8.CrossRef
32.
Mizrahi I, Beglaibter N, Simanovsky N, Lioubashevsky N, Mazeh H, Ghanem M, et al. Ultrasound evaluation of visceral and subcutaneous fat reduction in morbidly obese subjects undergoing laparoscopic gastric banding, sleeve gastrectomy, and Roux-en-Y gastric bypass: a prospective comparison study. Obes Surg. 2015;25(6):959–66.CrossRefPubMed
33.
Umemura A, Sasaki A, Nitta H, Otsuka K, Suto T, Wakabayashi G. Effects of changes in adipocyte hormones and visceral adipose tissue and the reduction of obesity-related comorbidities after laparoscopic sleeve gastrectomy in Japanese patients with severe obesity. Endocr J. 2014;61(4):381–91.CrossRefPubMed
34.
Santilli F, Vazzana N, Liani R, Guagnano MT, Davì G. Platelet activation in obesity and metabolic syndrome. Obes Rev Off J Int Assoc Study Obes. 2012;13(1):27–42.CrossRef
35.
Dias CC, Nogueira-Pedro A, Barbosa CMV, Ribeiro-Filho AC, Wasinski F, Araújo RC, et al. Hematopoietic stem cell expansion caused by a synthetic fragment of leptin. Peptides. 2013;50:24–7.CrossRefPubMed
36.
Minervino D, Gumiero D, Nicolazzi MA, Carnicelli A, Fuorlo M, Guidone C, et al. Leukocyte activation in obese patients: effect of bariatric surgery. Medicine (Baltimore). 2015;94(40):e1382.CrossRef
37.
Kwon Y, Kim HJ, Lo Menzo E, Park S, Szomstein S, Rosenthal RJ. Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: a meta-analysis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2014;10(4):589–97.CrossRef
38.
Weng T-C, Chang C-H, Dong Y-H, Chang Y-C, Chuang L-M. Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ Open. 2015;5(7):e006964.CrossRefPubMedPubMedCentral
39.
Evstatiev R, Bukaty A, Jimenez K, Kulnigg-Dabsch S, Surman L, Schmid W, et al. Iron deficiency alters megakaryopoiesis and platelet phenotype independent of thrombopoietin. Am J Hematol. 2014;89(5):524–9.CrossRefPubMedPubMedCentral
40.
Choi SI, Simone JV. Platelet production in experimental iron deficiency anemia. Blood. 1973;42(2):219–28.PubMed
41.
Kadikoylu G, Yavasoglu I, Bolaman Z, Senturk T. Platelet parameters in women with iron deficiency anemia. J Natl Med Assoc. 2006;98(3):398–402.PubMedPubMedCentral
42.
Durand P, Prost M, Blache D. Folic acid deficiency enhances oral contraceptive-induced platelet hyperactivity. Arterioscler Thromb Vasc Biol. 1997;17(10):1939–46.CrossRefPubMed
43.
McCarty MF. High-dose folate may improve platelet function in acute coronary syndrome and other pathologies associated with increased platelet oxidative stress. Med Hypotheses. 2007;69(1):12–9.CrossRefPubMed
44.
Cheng V, Kashyap SR, Schauer PR, Kirwan JP, McCrae KR. Restoration of glycemic control in patients with type 2 diabetes mellitus after bariatric surgery is associated with reduction in microparticles. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2013;9(2):207–12.CrossRef
Metadata
Title
Effect of Bariatric Surgery-Induced Weight Loss on Platelet Count and Mean Platelet Volume: a 12-Month Follow-Up Study
Authors
Loïc Raoux
David Moszkowicz
Karina Vychnevskaia
Tigran Poghosyan
Alain Beauchet
Sylvain Clauser
Marion Bretault
Sébastien Czernichow
Claire Carette
Jean-Luc Bouillot
Publication date
01-02-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2292-z

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