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This meta\u2010analysis evaluates the impact of obesity on parameters\u2014D\u2010dimer, fibrinogen, plasminogen activator inhibitor\u20101 (PAI\u20101), von Willebrand factor (vWF), factor VIII (FVIII), and endogenous thrombin potential (ETP)\u2014in children and adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty\u2010four studies comprising 59,503 individuals were analyzed. Plasma biomarker levels were compared between non\u2010obese and obese groups using standardized mean differences (SMDs), with subgroup analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      D\u2010dimer was significantly elevated in adults with obesity (SMD 1.36, 95% CI 0.47\u20132.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and children with obesity (SMD 0.77, 95% CI 0.19\u20131.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), indicating increased fibrin turnover. Fibrinogen levels were markedly higher in both adults (SMD 1.17, 95% CI 0.14\u20132.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and children (SMD 1.43, 95% CI 0.93\u20131.92,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). PAI\u20101 showed the most pronounced increase in adults (SMD 2.30, 95% CI 0.1.51\u20133.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and children (SMD 3.54, 95% CI 1.65\u20135.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002). FVIII levels were modestly elevated (SMD 0.52, 95% CI 0.10\u20130.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), whereas vWF levels showed inconsistent changes. ETP was significantly higher in obesity, in children (SMD 1.06, 95% CI 0.24\u20131.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and adults (SMD 0.71, 95% CI 0.46\u20130.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Gender\u2010stratified data indicated higher PAI\u20101, fibrinogen, and ETP levels in females.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obesity is associated with increased coagulation activation, suggesting a pro\u2010thrombotic shift. These findings support the need for age\u2010 and gender\u2010specific research into obesity\u2010related hemostatic alterations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/obr.70137","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T02:01:15Z","timestamp":1777255275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Obesity\u2010Related Coagulation Activation in Adolescents and Children: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"27","author":[{"given":"Julia","family":"Buchold","sequence":"first","affiliation":[{"name":"Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Jonas","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0070-3406","authenticated-orcid":false,"given":"Manuel\u00a0Florian","family":"Struck","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrey","family":"Kohli","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Mathew","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics University of Leipzig  Leipzig 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