Influence of weight reduction on platelet volume: different effects of a hypocaloric diet and a very low calorie diet.

Since platelet volume reflects platelet activity, the mean platelet volume (MPV) is proposed to be a further independent risk factor for cardiovascular disease (CVD). Even if it is well established that weight reduction reduces some of the risk factors of CVD in obese patients, an increase of MPV occurs during periods of weight loss. We therefore prospectively investigated the effects of different weight reduction therapies on platelet mass, platelet volume, body weight and serum lipid profile in patients undergoing an 8 week weight reduction therapy either by a hypocaloric diet (HD) or a nutritionally completed very low calorie diet (VLCD) with a subsequent maintenance period of 40 weeks. In both groups, MPV transiently increased during the 8 week diet period. After 48 weeks the MPV was decreased to initial values. The change in MPV was significantly (P < 0.05) smaller in the VLCD group. We therefore suggest that fasting might alter the control of platelet size with a possible impact on platelet activity. This might result in an increased risk for thromboembolic ischaemic events in atherosclerotic patients. Thus, we conclude that the use of a VLCD is potentially superior for weight reduction in patients with pre-existing atherosclerosis.

RCT Entities:   Population Interventions Outcomes