Obese patients more likely to get HIT

HIT, or heparin-induced thrombocytopenia, in its most common form is an immunologic disorder in which intravenous or subcutaneous heparin (a potent anticoagulant) administration induces antibodies which cause platelets in the blood to form extensive clots in both arteries and veins. Platelet count then drops precipitously. It is a serious disorder often resulting in limb loss or death. A recent study from Cedars-Sinai Medical Center in Los Angeles performed over the course of seven years on ICU patients demonstrated that obesity was strongly associated with the development of HIT. Patients who were obese had a 170% greater incidence of HIT which rose to 600% in morbidly obese patients. This study is the first report to show a strong association between obesity (as measured by BMI) and HIT. Obesity has been closely related to a variety of immune-mediated disorders such as rheumatoid arthritis, lupus and inflammatory bowel diseases.

The Prescription® Perspective:

HIT must be identified and treated quickly to minimize the likelihood of extensive clotting problems. Treatment involves cessation of heparin therapy and, in patients who need continued anticoagulation, an alternative medication should be administered. One of the dangers of HIT, which can take several days to develop initially, is that subsequent administration of heparin, even years later, can cause rapid recurrence of HIT which may produce extensive blood clotting before the problem can be identified. One small problem with the study is that the degree of obesity was classified based on body mass index (BMI) BMI calculation relies on body weight, which is dependent on several parameters (muscle mass, hydration status, bone density, e.g.)in addition to fat mass . As we all know, BMI is not the most accurate method for classification of obesity. The results would likely have been much more dramatic had body fat percentage been utilized instead of BMI.

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Significant weight loss has been clearly demonstrated to decrease inflammation generally
throughout the body. Any inflammatory disorder is improved by a significant reduction in body
fat percentage. This important study adds one more immunologic disorder to the growing list of
immunologic conditions that are worsened by excess body fat.

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