Cardiovascular risk associated with BMI and metabolic health phenotypes based on measures of coagulation factors.

Abstract Introduction: While the classification of metabolically healthy individuals with obesity remains uncertain, recent research links central obesity to thromboembolism and cardiovascular disease, potentially indicating a hypercoagulable state in some individuals with obesity. This study investigates coagulation and inflammation differences between obesity and normal-weight phenotypes. Methods: 225 adult women, participants were subjected to clinical examinations, and biochemical assessments. These assessments classified participants into four distinct phenotypes, namely MHNW (Metabolically Healthy Normal Weight), MUNW (Metabolically Unhealthy Normal Weight), MHO (Metabolically Healthy Obesity), and MUO (Metabolically Unhealthy Obesity), based on a combination of BMI and metabolic criteria. Subsequently hemostatic proteins and interleukin levels were compared. Results: Among 225 female patients, the MHO group was younger, with higher measurements like visceral fat and BMI, while MUO had the highest values in HOMA-IR, triglycerides and LDL-c. Coagulation proteins showed normal levels. However, MHNW had significantly lower FV, and groups without obesity (MHNW and MUNW) had lower FVIII and FIX. FXII in MHNW did not significantly differ. Inflammatory markers revealed IL-6 negatively correlated with PC and AT but positively with FVIII and FIX. IL-10 negatively correlated with FII, FV, FVII, FXI, and FXII, while TNF-α and IL-1 positively correlated with FVIII and FIX. Conclusion: This study challenges the MHNW metric, revealing metabolic marker elevations in non-obese groups. Additionally, MHO individuals exhibited pro-coagulant protein increases compared to MUO, suggesting limited clinical utility in categorizing the broader population with obesity. The interplay between metabolic health and body size phenotypes challenges traditional approaches to predicting health risks.