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Effect of Sleeve Gastrectomy on Platelet Counts and Mean Platelet Volumes

A Correction to this article was published on 21 May 2018

This article has been updated

Abstract

Background

Obesity is a chronic metabolic disorder associated with cardiovascular disease, characterized by a chronic proinflammatory and prothrombotic state. The size and hemostatic potential of circulating platelets (PLTs) differ, with larger PLTs containing more granules and producing greater amounts of vasoactive and prothrombotic factors. This study aimed to investigate the effect of laparoscopic sleeve gastrectomy (LSG) on PLT count and mean platelet volume (MPV) in morbidly obese patients.

Methods

Two hundred five patients (females, n = 143; males, n = 62) who attended monitoring visits in the period prior to LSG and for 6 months after surgery were included in this study. Routine physical examination findings and laboratory parameters recorded preoperatively were compared with the same parameters in the postoperative 6th month.

Results

The mean age of the patients was 37.36 ± 10.93 years. The mean preoperative body mass index (BMI) of the patients was 47.65 kg/m2, whereas the mean postoperative BMI at 6 months was 31.49 kg/m2. Prior to LSG, the mean PLT count was 314.16 ± 76.40 × 109/L. At the postoperative 6th month, the mean PLT count was significantly reduced (263.17 ± 65.67 × 109/L, p < 0.001). In the preoperative period, the MPV was 10.12 ± 0.88 fL. In the postoperative period, it was significantly increased (10.41 ± 1.23 fL, p > 0.001). Both preoperatively and postoperatively, PLT counts were significantly higher in females than in males. After LSG, the MPV increased in both females and males.

Conclusions

The results demonstrated that PLT counts decreased and MPV levels increased significantly after LSG and that the decrease in PLT counts was independent of changes in BMI.

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Fig. 1
Fig. 2

Change history

  • 21 May 2018

    In the original article, in the Results section of the Abstract the text “…(10.41 ± 1.23 fL, p > 0.001)” should be changed to “…(10.41 ± 1.23 fL, p < 0.001)”. The same error occurs on the next page of the article in the second paragraph of the Results section of the main text.

References

  1. Taura P, Polanco-Garcia M, Rivas E, et al. Can mean platelet volume be used as a biomarker of pathological fibrin clot strength related to obesity? Thromb Res. 2016;148:56–8.

    Article  PubMed  CAS  Google Scholar 

  2. Stein PD, Goldman J. Obesity and thromboembolic disease. Clin Chest Med. 2009;30:489–93.

    Article  PubMed  Google Scholar 

  3. Schäfer K, Konstantinides S. Adipokines and thrombosis. Clin Exp Pharmacol Physiol. 2011;38:864–71.

    Article  PubMed  CAS  Google Scholar 

  4. Samocha-Bonet D, Justo D, Rogowski O, et al. Platelet counts and platelet activation markers in obese subjects. Mediat Inflamm. 2008;2008:834153.

    Article  CAS  Google Scholar 

  5. 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.

    Article  PubMed  CAS  Google Scholar 

  6. Klöting N, Blüher M. Adipocyte dysfunction, inflammation and metabolic syndrome. Rev Endocr Metab Disord. 2014;15(4):277–87.

    Article  PubMed  CAS  Google Scholar 

  7. Kutlucan A, Bulur S, Kr S, et al. The relationship between mean platelet volume with metabolic syndrome in obese individuals. Blood Coagul Fibrinolysis. 2012;23(5):388–90.

    Article  PubMed  CAS  Google Scholar 

  8. Frojmovic MM, Milton JG. Human platelet size, shape, and related functions in health and disease. Physiol Rev. 1982;62:185–261.

    Article  PubMed  CAS  Google Scholar 

  9. Van der Loo B, Martin JF. Megakaryocytes and platelets in vascular disease. Baillieres Clin Haematol. 1997;10:109–23.

    Article  PubMed  Google Scholar 

  10. Furman-Niedziejko A, Rostoff P, Rychlak R, et al. Relationship between abdominal obesity, platelet blood count and mean platelet volume in patients with metabolic syndrome. Folia Med Cracov. 2014;54(2):55–64.

    PubMed  Google Scholar 

  11. Tsiara S, Elisaf M, Jagroop IA, et al. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost. 2003;9:177–90.

    Article  PubMed  CAS  Google Scholar 

  12. Broadley AJ, Gapper P, Schmitt M, et al. Supine rest reduces platelet activation and aggregation. Platelets. 2003;14:3–7.

    Article  PubMed  CAS  Google Scholar 

  13. Yilmaz MA, Duran C, Basaran M. The mean platelet volume and neutrophil to lymphocyte ratio in obese and lean patients with polycystic ovary syndrome. J Endocrinol Investig. 2016;39(1):45–53.

    Article  CAS  Google Scholar 

  14. Endler G, Klimesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol. 2002;117:399–404.

    Article  PubMed  Google Scholar 

  15. Du J, Wang Q, He B, et al. Association of mean platelet volume and platelet count with the development and prognosis of ischemic and hemorrhagic stroke. Int J Lab Hematol. 2016;38(3):233–9.

    Article  PubMed  CAS  Google Scholar 

  16. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996;7:157–61.

    Article  PubMed  CAS  Google Scholar 

  17. Demir M, Cosar S, Melek M. Evaluation of plasma eosinophil count and mean platelet volume in patients with coronary slow flow. Clinics. 2014;69(5):323–6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sahin DY, Gur M, Elbasan Z, et al. Mean platelet volume associated with aortic distensibility, chronic inflammation, and diabetes in patients with stable coronary artery disease. Clin Appl Thromb Hemost. 2014;20(4):416–21.

    Article  PubMed  Google Scholar 

  19. Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47–58.

    Article  PubMed  CAS  Google Scholar 

  20. Martin JF, Trowbridge EA, Salmon G, et al. The biological significance of platelet volume: its relationship to bleeding time, thromboxane B2 production and megakaryocyte nuclear DNA concentration. Thromb Res. 1983;32:443–60.

    Article  PubMed  CAS  Google Scholar 

  21. Coban E, Ozdogan M, Yazicioglu G, et al. The mean platelet volume in patients with obesity. Int J Clin Pract. 2005;59:981–2.

    Article  PubMed  CAS  Google Scholar 

  22. Tavil Y, Sen N, Yazici HU, et al. Mean platelet volüme in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res. 2007;120:245–50.

    Article  PubMed  CAS  Google Scholar 

  23. Muscari A, De Pascalis S, Cenni A, et al. Determinants of mean platelet volume (MPV) in an elderly population: relevance of body fat, blood glucose and ischaemic electrocardiographic changes. Thromb Haemost. 2008;99:1079–84.

    Article  PubMed  CAS  Google Scholar 

  24. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.

    Article  PubMed  CAS  Google Scholar 

  25. Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.

    Article  PubMed  Google Scholar 

  26. Nakata M, Yada T, Soejima N, et al. Leptin promotes aggregation of human platelets via the long form of its receptor. Diabetes. 1999;48(2):426–9.

    Article  PubMed  CAS  Google Scholar 

  27. Konstantinides S, Schafer K, Koschnick S, et al. Leptin-dependent platelet aggregation and arterial thrombosis suggests a mechanism for atherothrombotic 6 mediators of inflammation disease in obesity. J Clin Investig. 2001;108(10):1533–40.

    Article  PubMed  CAS  Google Scholar 

  28. Licata G, Scaglione R, Giammarresi C, et al. No evidence of platelet activation in obesity. Thromb Haemost. 1993;70(3):544.

    PubMed  CAS  Google Scholar 

  29. De Pergola G, Pannacciulli N, Coviello M. sP-selectin plasma levels in obesity: association with insulin resistance and related metabolic and prothrombotic factors. Nutr Metab Cardiovasc Dis. 2008;18(3):227–32.

    Article  PubMed  CAS  Google Scholar 

  30. 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.

    CAS  Google Scholar 

  31. Golzarand M, Toolabi K, Farid R. The bariatric surgery and weight losing: a meta-analysis in the long and very long term effect of laparoscopic adjustable gastric banding., laparoscopic Roux-en Y gastric bypass and laparoscopic sleeve gastrectomy on weight loss in adults. Surg Endosc. 2017;31(11):4331–45.

    Article  PubMed  Google Scholar 

  32. Angrisani L, Santonicola A, Iovino P, et al. Bariatric Surgery Worldwide 2013. Obes Surg. 2015;25(10):1822–32.

    Article  PubMed  CAS  Google Scholar 

  33. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:CD003641.

    Google Scholar 

  34. Anfossi G, Russo I, Trovati M. Platelet dysfunction in central obesity. Nutr Metab Cardiovasc Dis. 2009;19(6):440–9.

    Article  PubMed  CAS  Google Scholar 

  35. Periasamy M, Lieb DC, Butcher MJ, et al. Bariatric surgery decreases monocyte-platelet aggregates in blood: a pilot study. Obes Surg. 2014;24(8):1410–4.

    Article  PubMed  Google Scholar 

  36. Alessi MC, Juhan-Vague I. Metabolic syndrome, haemostasis and thrombosis. Thromb Haemost. 2008;99(6):995–1000.

    Article  PubMed  CAS  Google Scholar 

  37. National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med. 2000;160(7):898–904.

    Article  Google Scholar 

  38. Despre’s JP. Cardiovascular disease under the influence of excess visceral fat. Crit Pathw Cardiol. 2007;6(2):51–9.

    Article  Google Scholar 

  39. Montilla M, Santi MJ, Carrozas MA, et al. Biomarkers of the prothrombotic state in abdominal obesity. Nutr Hosp. 2014;31(3):1059–66.

    PubMed  Google Scholar 

  40. Santilli F, Vazzana N, Liani R, et al. Platelet activation in obesity and metabolic syndrome. Obes Rev. 2012;13(1):27–42.

    Article  PubMed  CAS  Google Scholar 

  41. Thaulow E, Erikssen J, Sandvik L, et al. Blood platelet count and function are related to total and cardiovascular death in apparently healthy men. Circulation. 1991;84(2):613–7.

    Article  PubMed  CAS  Google Scholar 

  42. Csongrádi É, Káplár M, Nagy Jr B, et al. Adipokines as atherothrombotic risk factors in obese subjects: associations with haemostatic markers and common carotid wall thickness. Nutr Metab Cardiovasc Dis. 2017;27(6):571–80.

    Article  PubMed  CAS  Google Scholar 

  43. Pizzi C, De Stavola BL, Meade TW. Long-term association of routine blood count (Coulter) variables on fatal coronary heart disease: 30-year results from the first prospective Northwick Park Heart Study (NPHS-I). Int J Epidemiol. 2010;39(1):256–65.

    Article  PubMed  Google Scholar 

  44. Van Der Bom JG, Heckbert SR, Lumley T, et al. Platelet count and the risk for thrombosis and death in the elderly. J Thromb Haemost. 2009;7(3):399–405.

    Article  PubMed  Google Scholar 

  45. Raoux L, Moszkowicz D, Vychnevskaia K, et al. Effect of bariatric surgery-induced weight loss on platelet count and mean platelet volume: a 12-month follow-up study. Obes Surg. 2017;27(2):387–93.

    Article  PubMed  Google Scholar 

  46. Dallal RM, Leighton J, Trang A. Analysis of leukopenia and anemia after gastric bypass surgery. Surg Obes Relat Dis. 2012;8(2):164–8.

    Article  PubMed  Google Scholar 

  47. Brooks GC, Blaha MJ, Blumenthal RS. Relation of C-reactive protein to abdominal adiposity. Am J Cardiol. 2010;106(1):56–61.

    Article  PubMed  CAS  Google Scholar 

  48. Johansson H-E, Haenni A, Zethelius B. Platelet counts and liver enzymes after bariatric surgery. J Obes. 2013;2013:567984.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  49. Adler BJ, Kaushansky K, Rubin CT. Obesity-driven disruption of haematopoiesis and the bone marrow niche. Nat Rev Endocrinol. 2014;10(12):737–48.

    Article  PubMed  CAS  Google Scholar 

  50. Tymitz K, Engel A, McDonough S, et al. Changes in ghrelin levels following bariatric surgery: review of the literature. Obes Surg. 2011;21(1):125–30.

    Article  PubMed  Google Scholar 

  51. Woelnerhanssen B, Peterli R, Steinert RE, et al. 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. 2011;7(5):561–8.

    Article  PubMed  Google Scholar 

  52. Kwon Y, Kim HJ, Lo Menzo E, et al. Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: a meta-analysis. Surg Obes Relat Dis. 2014;10(4):589–97.

    Article  PubMed  Google Scholar 

  53. Weng TC, Chang CH, Dong YH, et al. Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ Open. 2015;5(7):e006964.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Kadikoylu G, Yavasoglu I, Bolaman Z, et al. Platelet parameters in women with iron deficiency anemia. J Natl Med Assoc. 2006;98(3):398–402.

    PubMed  PubMed Central  Google Scholar 

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Correspondence to Faruk Kutluturk.

Ethics declarations

To conduct the study, approval of the Clinical Research Ethics Committee of the Faculty of Medicine, University of Gaziosmanpasa University was obtained (17-KAEK-167). The study was carried out in accordance with the Declaration of Helsinki (2013) of the World Medical Association.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Kutluturk, F., Ozsoy, Z. Effect of Sleeve Gastrectomy on Platelet Counts and Mean Platelet Volumes. OBES SURG 28, 3159–3164 (2018). https://doi.org/10.1007/s11695-018-3287-8

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  • DOI: https://doi.org/10.1007/s11695-018-3287-8

Keywords

  • Obesity
  • Sleeve gastrectomy
  • Platelet
  • Mean platelet volume
  • Cardiovascular risk factors