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Clinical Research

Cardiovascular risk factors associated with BMI and metabolic health phenotypes based on measures of coagulation factors

International Journal of Obesity (2025)Cite this article

Subjects

Abstract

Introduction

While the classification of metabolically healthy individuals with obesity remains uncertain, recent research links central obesity to thromboembolism and cardiovascular disease, potentially indicating a hypercoagulable state in some individuals with obesity. This study investigates coagulation and inflammation differences between obesity and normal-weight phenotypes.

Methods

225 adult women, participants were subjected to clinical examinations, and biochemical assessments. These assessments classified participants into four distinct phenotypes, namely MHNW (individuals with Metabolically Healthy Normal Weight), MUNW (individuals with Metabolically Unhealthy Normal Weight), MHO (individuals with Metabolically Healthy Obesity), and MUO (individuals with Metabolically Unhealthy Obesity), based on a combination of body mass index (BMI) and metabolic criteria. Subsequently, hemostatic proteins and interleukin levels were compared.

Results

Among 225 female patients, the MHO group was younger, with higher measurements like visceral fat and BMI, while MUO had the highest values in homeostatic model assessment for insulin resistance (HOMA-IR), triglycerides and low-density lipoprotein cholesterol (LDL-c). Coagulation proteins showed normal levels. However, MHNW had significantly lower FV, and groups without obesity (MHNW and MUNW) had lower FVIII and FIX. FXII in MHNW did not significantly differ. Inflammatory markers revealed IL-6 negatively correlated with PC and AT but positively with FVIII and FIX. IL-10 negatively correlated with FII, FV, FVII, FXI, and FXII, while TNF-α and IL-1 positively correlated with FVIII and FIX.

Conclusion

This study challenges the MUNW metric, revealing metabolic marker elevations in women without obesity. Additionally, MHO individuals exhibited pro-coagulant protein increases compared to MUO, suggesting limited clinical utility in categorizing the broader population with obesity. Our exploratory findings highlight how the interplay between metabolic health and body size phenotypes could challenge conventional frameworks for assessing health risk.

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Data availability

The datasets analyzed during the current study are not publicly available due to ethical and institutional restrictions. However, they are available from the corresponding author upon request and with approval from the institutional ethics committee. No custom code was generated for this analysis.

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Authors and Affiliations

  1. Endocrine Research Unit, Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    María M. Valle, Jennyfer Gaspar & Sara Vega-Garcia

  2. National School of Biological Sciences, Instituto Politécnico Nacional, México City, Mexico

    María M. Valle, Elba Reyes-Maldonado & Erika Rosales

  3. Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA

    Ariadna Robledo & Sean O’Leary

  4. Hospital de la Mujer, Coordinating Commission of National Institutes of Health and High Specialty Hospitals (CCINSHAE), Secretaría de Salud, Mexico City, Mexico

    Lourdes Basurto

  5. Hematology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico

    Carlos Martínez-Murillo

Authors
  1. María M. Valle
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  2. Ariadna Robledo
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  4. Lourdes Basurto
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  8. Sara Vega-Garcia
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Contributions

MM Valle: Data Collection, methodology, writing original draft preparation; A Robledo and S O’Leary: Data processing, writing original draft preparation; E Reyes, J Gaspar, C Martínez-Murillo: Writing—Reviewing and editing; E Rosales and Vega-García S: Methodology; L Basurto: Data collection, methodology, obtaining financing, data processing, project administration, writing original draft preparation.

Corresponding author

Correspondence to Lourdes Basurto.

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The authors declare no competing interests.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki and applicable institutional and national regulations. The protocol and consent materials were reviewed and approved by the Ethics and Research Committee of the Mexican Social Security Institute (IMSS). All participants were adults and only de-identified data were analyzed. The study involved minimal risk, and no clinical interventions were performed. No identifiable images or personal data are included in this manuscript.

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Valle, M.M., Robledo, A., O’Leary, S. et al. Cardiovascular risk factors associated with BMI and metabolic health phenotypes based on measures of coagulation factors. Int J Obes (2025). https://doi.org/10.1038/s41366-025-01915-1

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