Obesity-Related Coagulation Activation in Adolescents and Children: A Systematic Review and Meta-Analysis

IF 7.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Reviews Pub Date : 2026-09-08 Epub Date: 2026-04-26 DOI:10.1111/obr.70137

Julia Buchold, Hans-Jonas Meyer, Manuel Florian Struck, Shrey Kohli, Akash Mathew, Gyulten Mangova, Alexey Surov, Matthias Blüher, Berend Isermann, Silke Zimmermann

{"title":"Obesity-Related Coagulation Activation in Adolescents and Children: A Systematic Review and Meta-Analysis","authors":"Julia Buchold, Hans-Jonas Meyer, Manuel Florian Struck, Shrey Kohli, Akash Mathew, Gyulten Mangova, Alexey Surov, Matthias Blüher, Berend Isermann, Silke Zimmermann","doi":"10.1111/obr.70137","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <p>Obesity is recognized as a pro-thrombotic condition, yet the extent of coagulation activation across biomarkers remains unclear. This meta-analysis evaluates the impact of obesity on parameters—D-dimer, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF), factor VIII (FVIII), and endogenous thrombin potential (ETP)—in children and adults.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Sixty-four studies comprising 59,503 individuals were analyzed. Plasma biomarker levels were compared between non-obese and obese groups using standardized mean differences (SMDs), with subgroup analyses.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>D-dimer was significantly elevated in adults with obesity (SMD 1.36, 95% CI 0.47–2.25, <i>p</i> = 0.003) and children with obesity (SMD 0.77, 95% CI 0.19–1.36, <i>p</i> = 0.009), indicating increased fibrin turnover. Fibrinogen levels were markedly higher in both adults (SMD 1.17, 95% CI 0.14–2.20, <i>p</i> = 0.03) and children (SMD 1.43, 95% CI 0.93–1.92, <i>p</i> < 0.0001). PAI-1 showed the most pronounced increase in adults (SMD 2.30, 95% CI 0.1.51–3.09, <i>p</i> < 0.0001) and children (SMD 3.54, 95% CI 1.65–5.43, <i>p</i> = 0.0002). FVIII levels were modestly elevated (SMD 0.52, 95% CI 0.10–0.94, <i>p</i> = 0.02), whereas vWF levels showed inconsistent changes. ETP was significantly higher in obesity, in children (SMD 1.06, 95% CI 0.24–1.88, <i>p</i> = 0.01) and adults (SMD 0.71, 95% CI 0.46–0.97, <i>p</i> < 0.0001). Gender-stratified data indicated higher PAI-1, fibrinogen, and ETP levels in females.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Obesity is associated with increased coagulation activation, suggesting a pro-thrombotic shift. These findings support the need for age- and gender-specific research into obesity-related hemostatic alterations.</p>\n </section>\n </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 10","pages":""},"PeriodicalIF":7.6000,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70137","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity Reviews","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/obr.70137","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/4/26 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Obesity is recognized as a pro-thrombotic condition, yet the extent of coagulation activation across biomarkers remains unclear. This meta-analysis evaluates the impact of obesity on parameters—D-dimer, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF), factor VIII (FVIII), and endogenous thrombin potential (ETP)—in children and adults.

Methods

Sixty-four studies comprising 59,503 individuals were analyzed. Plasma biomarker levels were compared between non-obese and obese groups using standardized mean differences (SMDs), with subgroup analyses.

Results

D-dimer was significantly elevated in adults with obesity (SMD 1.36, 95% CI 0.47–2.25, p = 0.003) and children with obesity (SMD 0.77, 95% CI 0.19–1.36, p = 0.009), indicating increased fibrin turnover. Fibrinogen levels were markedly higher in both adults (SMD 1.17, 95% CI 0.14–2.20, p = 0.03) and children (SMD 1.43, 95% CI 0.93–1.92, p < 0.0001). PAI-1 showed the most pronounced increase in adults (SMD 2.30, 95% CI 0.1.51–3.09, p < 0.0001) and children (SMD 3.54, 95% CI 1.65–5.43, p = 0.0002). FVIII levels were modestly elevated (SMD 0.52, 95% CI 0.10–0.94, p = 0.02), whereas vWF levels showed inconsistent changes. ETP was significantly higher in obesity, in children (SMD 1.06, 95% CI 0.24–1.88, p = 0.01) and adults (SMD 0.71, 95% CI 0.46–0.97, p < 0.0001). Gender-stratified data indicated higher PAI-1, fibrinogen, and ETP levels in females.

Conclusion

Obesity is associated with increased coagulation activation, suggesting a pro-thrombotic shift. These findings support the need for age- and gender-specific research into obesity-related hemostatic alterations.

查看原文本刊更多论文

青少年和儿童肥胖相关凝血激活：系统回顾和荟萃分析。

肥胖被认为是一种促血栓形成的条件，但凝血激活的生物标志物的程度仍不清楚。本荟萃分析评估了肥胖对儿童和成人参数d -二聚体、纤维蛋白原、纤溶酶原激活物抑制剂-1 （PAI-1）、血管性血友病因子（vWF）、因子VIII （FVIII）和内源性凝血酶电位（ETP）的影响。方法：对64项研究59,503人进行分析。使用标准化平均差异（SMDs）比较非肥胖组和肥胖组的血浆生物标志物水平，并进行亚组分析。结果：d -二聚体在肥胖成人（SMD 1.36, 95% CI 0.47-2.25, p = 0.003）和肥胖儿童（SMD 0.77, 95% CI 0.19-1.36, p = 0.009）中显著升高，表明纤维蛋白周转增加。成人（SMD 1.17, 95% CI 0.14-2.20, p = 0.03）和儿童（SMD 1.43, 95% CI 0.93-1.92, p）的纤维蛋白原水平均明显升高。结论：肥胖与凝血激活增加有关，提示促血栓转移。这些发现支持了对肥胖相关的止血改变进行年龄和性别特异性研究的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Obesity Reviews 医学-内分泌学与代谢

CiteScore

19.30

自引率

1.10%

发文量

130

审稿时长

1 months

期刊介绍： Obesity Reviews is a monthly journal publishing reviews on all disciplines related to obesity and its comorbidities. This includes basic and behavioral sciences, clinical treatment and outcomes, epidemiology, prevention and public health. The journal should, therefore, appeal to all professionals with an interest in obesity and its comorbidities. Review types may include systematic narrative reviews, quantitative meta-analyses and narrative reviews but all must offer new insights, critical or novel perspectives that will enhance the state of knowledge in the field. The editorial policy is to publish high quality peer-reviewed manuscripts that provide needed new insight into all aspects of obesity and its related comorbidities while minimizing the period between submission and publication.