Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam, the Netherlands
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Department of Plasma Proteins, Sanquin Research, Amsterdam, the Netherlands
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Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Introduction An effect on markers of coagulation and fibrinolysis has been hypothesized for hyperparathyroidism as primary hyperparathyroidism is associated with an increased risk of cardiovascular (CV) morbidity and mortality ( 1 , 2 , 3
Department of Clinical Biochemistry, Hospital of South West Jutland, Esbjerg, Denmark
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
Department of Internal Medicine, Lillebaelt Hospital, Kolding, Denmark
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Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
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Department of Clinical Biochemistry, Hospital of South West Jutland, Esbjerg, Denmark
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Department of Clinical Biochemistry, Hospital of South West Jutland, Esbjerg, Denmark
Department of Haematology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
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Department of Clinical Biochemistry, Hospital of South West Jutland, Esbjerg, Denmark
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decreased propensity for fibrinolysis has been previously proposed in KS VTE case series ( 1 , 10 , 11 ). Decreased fibrinolytic capacity is independently associated with an increased risk of VTE ( 12 , 13 ). Decreased fibrinolytic capacity has been
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Department of Internal Medicine, Endocrine Unit, Herlev Gentofte Hospital, Herlev, Denmark
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Department of Internal Medicine, Endocrine Unit, Herlev Gentofte Hospital, Herlev, Denmark
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Department of Internal Medicine, Endocrine Unit, Herlev Gentofte Hospital, Herlev, Denmark
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Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Polycystic ovary syndrome (PCOS) is associated with increased risk of venous thromboembolism (VTE) and cardiovascular disease (CVD) in later life. We aimed to study the effect of liraglutide intervention on markers of VTE and CVD risk, in PCOS. In a double-blind, placebo-controlled, randomized trial, 72 overweight and/or insulin-resistant women with PCOS were randomized, in a 2:1 ratio, to liraglutide or placebo 1.8 mg/day. Endpoints included between-group difference in change (baseline to follow-up) in plasminogen activator inhibitor-1 levels and in thrombin generation test parameters: endogenous thrombin potential, peak thrombin concentration, lag time and time to peak. Mean weight loss was 5.2 kg (95% CI 3.0–7.5 kg, P < 0.001) in the liraglutide group compared with placebo. We detected no effect on endogenous thrombin potential in either group. In the liraglutide group, peak thrombin concentration decreased by 16.71 nmol/L (95% CI 2.32–31.11, P < 0.05) and lag time and time to peak increased by 0.13 min (95% CI 0.01–0.25, P < 0.05) and 0.38 min (95% CI 0.09–0.68, P < 0.05), respectively, but there were no between-group differences. There was a trend toward 12% (95% CI 0–23, P = 0.05) decreased plasminogen activator inhibitor-1 in the liraglutide group, and there was a trend toward 16% (95% CI −4 to 32, P = 0.10) reduction, compared with placebo. In overweight women with PCOS, liraglutide intervention caused an approximate 5% weight loss. In addition, liraglutide affected thrombin generation, although not significantly differently from placebo. A concomitant trend toward improved fibrinolysis indicates a possible reduction of the baseline thrombogenic potential. The findings point toward beneficial effects of liraglutide on markers of VTE and CVD risk, which should be further pursued in larger studies.
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properties of the clot and its resistance to fibrinolysis, and appears altered in a variety of diseases of thrombotic or hemorrhagic phenotypes ( 16 , 17 ). We hypothesized that supplementation with vitamin D in deficient patients would be associated with
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hyperinsulinemia has been associated with impaired fibrinolysis ( 5 ). Diabetic patients have elevated levels of coagulation factors and impaired fibrinolysis, inducing a hypercoagulable state that may contribute to the increased risk of atherothrombotic events and
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contributes to many metabolic disorders, including hypercoagulation, hypo-fibrinolysis, dyslipidemia and hypertension ( 3 ). The hyperinsulinemic-euglycemic clamp technique is the gold standard for evaluating insulin resistance in humans but is costly for
Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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platelets, increased thrombin generation, elevated concentrations of fibrinogen and fibrinolysis inhibitors, and compensatory elevation of endogenous anticoagulants such as protein C and protein S ( 3 , 4 , 5 , 6 ). However, no linear relationship with
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University of Glasgow, Office for Rare Conditions, Glasgow, UK
University of Glasgow, Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, UK
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concentrations ( 11 , 12 ), impaired fibrinolysis ( 4 ) and endothelial dysfunction ( 13 ). Changes in pro- and anticoagulant factors may persist after successful surgery or medical therapy for at least several months ( 14 , 15 ). Given the lack of evidence
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preparation do not recommend these steps. Other/non-classical cardiovascular risk factors in PCOS PCOS is also associated with changes in circulating factors of coagulation and fibrinolysis, such as increased levels of factor VIIc, von
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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Department of Medicine, Karlstad Hospital, Karlstad, Sweden
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fibrinolysis ( 15 , 16 ). Binding of uPA to uPAR facilitates cleavage and generation of soluble uPAR (suPAR). suPAR positively correlates to the activation of the inflammatory and immune systems and is present in blood, urine and cerebrospinal fluid ( 15 , 16