VWF and metabolic syndrome: Altered carbohydrate metabolism, dyslipidemia, hypertension, and obesity lead to increased PAI-1, vWF, VE-cad, TM, and VEGF production; a condition responsible for impaired anticoagulant and fibrinolytic activity which can cause hypercoagulability: a low fibrinolytic and high viscosity state, and promote the formation of microthrombi (Wei et al., 2014).