**5. Metabolic syndrome and thrombosis: view from the mechanism**

Metabolic syndrome is characterized as the presence of three apparent characteristics including visceral obesity manifested as increasing waist circumference, dyslipidemia, hypertension, and high blood glucose. Underlining pathophysiology is insulin resistance and lipid accumulation. It is noteworthy that various cytokines (adipocytokines) were identified from adipose tissue. Adiponectin is the one identified as factor reducing the risk of thrombosis by preventing endothelial dysfunction [48]. Indeed, decreased plasma concentration of adiponectin observed in obese patients may suggest the potential regulatory role of adiponectin for the onset of thrombotic diseases [49]. Despite difficulty in understanding the precise relationship among various cytokines and adiponectin [50], an apparent link between metabolic syndrome and decreased adiponectin is noteworthy. Various parameters for coagulation and fibrinolysis are also influenced in metabolic syndrome patients [51]. It is reasonable to recommend regular exercise to prevent metabolic syndrome and future onset of thrombosis [52].
