It has been shown that
weight loss and physical activity contribute to a better biorheological profile. Yet, the concentrations of
fibrinogen are not always reduced following life style modification. We evaluated the inter-relations between
fibrinogen's pro red cell aggregation potential and reduced
inflammation and improved
lipid profile as anti-aggregating forces in a group of 20 apparently healthy obese volunteers following 4 and 8 months of intensive life modification program which included diet and strenuous physical activity. A significant (p=0.005)
weight loss (from a mean+/-SD of 121.4+/-20.9 to 98.0+/-21.3 kg) and decrease in body mass index (from 40.8+/-4.3 to 32.9+/-5.3 kg/m(2), p=0.005) was noted in fourteen individuals who completed the 8-month program. The concentrations of clottable
fibrinogen rose from 318+/-96 to 387+/-72 mg/dl (p=0.012) while there was a significant reduction in the erythrocyte sedimentation rate (ESR) (from 19.0+/-12.6 to 10.8+/-7.5 mm/h, p=0.018),
triglycerides (from 143+/-80 to 80+/-44 mg/dl, p=0.005),
LDL cholesterol (from 128+/-34 to 103+/-17 mg/dl, p=0.005) and total
cholesterol (from 211+/-40 to 171+/-17 mg/dl, p=0.007), as well as decrease in
insulin concentration (from 36.1+/-21.3 to 20.6+/-8.0 microu/ml, p=0.01) and the
insulin resistance index (HOMA-R, from 9.1+/-6.4 to 4.9+/-2.1 glu*ins/405, p=0.008). Despite a significant increment in the concentrations of clottable
fibrinogen, a significant reduction was noted in the degree of red cell aggregation as measured by using a slide test and direct visualization of the aggregates. Our conclusion is that the pro-aggregating properties of
fibrinogen following intense physical activity are probable counterbalanced by the anti-aggregatory properties of an improved
lipid profile and an attenuated
acute phase response.