A.Y. Cihan

I. Pabinger

Haematologica

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haematologica online 2007haematologica/the hematology journal | 2007; 92(online) | 65 |Metabolic syndrome and venous thrombosis: potential role of microparticlesHaematologica 2007; 92:(5)e65To the Editor, We thank the authors (Anders E. and Goichot B.) fortheir interest in our study, in which we have describedan increased risk of venous thromboembolism (VTE) inthe presence of the metabolic syndrome.1 The metabolicsyndrome comprises abdominal obesity (elevated waistcircumference), elevated blood pressure, high triglyc-erides, reduced levels of high-density lipoprotein choles-terol and elevated fasting glucose plasma levels and is awell known risk factor for type 2 diabetes and athero-sclerotic cardiovascular disease and cerebrovascular dis-ease.2 Obesity defined by a body mass index (BMI) above30 kg/m2 is not reflected in the definition of the metabol-ic syndrome. Indeed, we have observed in our study thatthe presence of the metabolic syndrome was significant-ly associated with the BMI and obesity.1In their comment concerning our paper on VTE as amanifestation of the metabolic syndrome the authorsnote that we missed to discuss the potential role of cir-culating procoagulant microparticles in the pathophysi-ology of venous thrombosis. Unfortunately we wereunable to measure circulating microparticles for thisstudy. Goichot and co-workers have reported markedlyincreased circulating microparticles in obese womencompared to normal weight control subjects in a prelim-inary study and concluded that the increase of circulat-ing microparticles in obese subjects may reflect cell acti-vation and could account for the increased risk of throm-botic complications in obesity.3 To the best of our knowl-edge up to now there is no study available reporting onan association of circulating microparticles and the riskfor VTE and giving us sufficient evidence for the poten-tial role of MP in the clinical manifestation of VTE. In thediscussion of our publication we addressed those mark-ers and parameters with a potential role in the patho-physiology of the metabolic syndrome as a risk factor forVTE that are already mentioned in the literature. As dataon microparticles and VTE are actually missing we didnot speculate on this issue.We again are thankful to the authors for their interest-ing comment about the potential role of microparticles inthe pathophysiology of venous thrombosis in the pres-ence of the metabolic syndrome and propose to measureprocoagulant circulating microparticles in future studiesto investigate their relationship with VTE and with themetabolic syndrome.A.Y. Cihan, I. PabingerDivision of Haematology and Haemostaseology, Department ofInternal Medicine I, Medical University Vienna, Vienna, Austria Tel: +43 1 40400 4417; Fax: +43 1 40400 40 30e-mail: ingrid.pabinger@meduniwien.ac.atReferences1. Ay C, Tengler T, Vormittag R, Simanek R, Dorda W, VukovichT, et al. Venous thromboembolism--a manifestation of themetabolic syndrome. Haematologica. 2007 Mar;92(3):374-80.2. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH,Franklin BA, et al. Diagnosis and management of the metabol-ic syndrome: an American Heart Association/National Heart,Lung, and Blood Institute Scientific Statement. Circulation.2005 Oct 25;112(17):2735-52.3. Goichot B, Grunebaum L, Desprez D, Vinzio S, Meyer L,Schlienger JL, et al. Circulating procoagulant microparticles inobesity. Diabetes & metabolism. 2006 Feb;32(1):82-5.

Metabolic syndrome and venous thrombosis: potential role of microparticles

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Metabolic syndrome and venous thrombosis: potential role of microparticles

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