Volume 106, Issue 3 pp. 306-319
Review Article
Free Access

The hematologic consequences of obesity

Johanna C. Purdy MD

Corresponding Author

Johanna C. Purdy MD

Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, OR, USA

Correspondence

Joseph Shatzel, MD, Division of Hematology and Oncology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.

Email: [email protected]

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Joseph J. Shatzel MD

Joseph J. Shatzel MD

Division of Hematology and Oncology, Oregon Health & Science University, Portland, OR, USA

Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA

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First published: 03 December 2020
Citations: 124

Abstract

The prevalence of obesity is increasing and progressively influencing physician-patient interactions. While there is a sizable amount of data demonstrating that obesity is a state of low-grade inflammation, to our knowledge, there is no single review summarizing its effects on hematologic parameters and thrombotic risk. We performed a literature search which largely surfaced observational studies, with a few systematic reviews and meta-analyses of these studies. We took care to review the mechanisms driving an inflammatory state and obesity's effect on white blood cells, red blood cells, platelets, and thrombotic risk. There is an observed relative, and sometimes absolute leukocytosis driven by this inflammatory state. Obesity is also associated with increased platelet counts and an increased risk for venous thromboembolism (VTE). Lastly, the association between obesity, iron deficiency (ID), and red blood cell counts may be present but remains uncertain. Recognizing the above associations may provide clinicians with reassurance regarding otherwise unexplained hematologic abnormalities in obese individuals. We hope this review will prompt future studies to further understand the underlying mechanisms driving these abnormalities and identify modifiable risk factors and potential therapeutic targets to prevent the development of probable obesity-associated conditions with significant morbidity and mortality, such as ID and VTE.

DATA AVAILABILITY STATEMENT

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

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