Does obesity affect the plasma level of Plasminogen Activator Inhibitor-1? And does CO2 pneumoperitoneum affect it?

Abstract

BackgroundThis prospective controlled study was designed to evaluate the effect of obesity on the plasma level of Plasminogen Activator Inhibitor-1 (PAI-1) and also to evaluate the effect of CO2 pneumoperitoneum on the plasma level of PAI-1 in patients underwent laparoscopic surgery.MethodsThe study included two groups; first group (non obese) included 30 patients with normal average BMI underwent laparoscopic cholecystectomy while the second group included 30 obese patients with BMI > 30 kg/m2 underwent laparoscopic band ligation or fundoplication surgery. Five ml of venous blood was collected from each patient in the non obese group once before induction of anesthesia while three venous blood samples (5 ml) were collected from each patient in the obese group as follows: first sample was taken before induction of anesthesia to compare it with the non obese group, second sample was taken after 1 h of CO2 insufflations (to know the effect of CO2 insufflations on PAI-1 level) and third sample was taken 1 week after surgery (to know the remaining effect in the postoperative period).ResultsThe level of PAI-1 was significantly high (5.423 ± 2.5 ng/ml) in the obese patients compared to non obese patients (1.4 ± 0.641 ng/ml) (P value = 0.001). The level of PAI-1 was significantly high after CO2 insufflations compared to baseline level (6.396 ± 2.542 ng/ml vs. 5.423 ± 2.5 ng/ml) in obese group (P value = 0.001). And this level also showed significant increase up to 1 week (6.01 ± 2.492 ng/ml vs. 5.423 ± 2.5 ng/ml) (P value = 0.028) in the obese group.ConclusionThe PAI-1 level was higher in obese patients when compared to non obese patients. PAI-1 level was elevated after CO2 insufflations and this elevation did not reach base line level up to 1 week after laparoscopic surgery.