Insulin Sensitivity and Hemostatic Factors in Clinically Healthy 58-year-old Men

PANNACCIULLI, NICOLA, VITO DE MITRIO, RENATO MARINO, RICCARDO GIORGINO, AND GIOVANNI DE PERGOLA. Effect of glucose tolerance status on PAI-1 plasma levels in overweight and obese subjects. Obes Res. 2002;10:717-725. Objective: The aim of our study was to examine whether plasminogen activator inhibitor-1 (PAI-1) plasma levels varied as a function of differences in glucose tolerance status independently of body fatness, body-fat distribution, and insulin sensitivity. Research Methods and Procedures: Plasma PAI-1 antigen levels, along with insulin resistance [measured by homeostatic model assessment (HOMA IR )], central fat accumulation, body composition, blood pressure, and fasting concentrations of glucose, insulin, and lipids, were measured in 229 overweight and obese [body mass index (BMI) Ն25 kg/m 2 ) subjects with normal glucose tolerance (NGT) and in 44 age-and BMI-matched subjects with impaired glucose tolerance (IGT). Results: Plasma PAI-1 antigen levels were significantly higher in IGT than in NGT subjects. Log PAI-1 was positively correlated with BMI, HOMA IR , and log insulin, and inversely associated with high-density lipoprotein-cholesterol both in IGT and in NGT individuals. On the other hand, log PAI-1 was positively correlated with waist circumference, fat mass (FM), fat-free mass, systolic and diastolic blood pressure, and log triglycerides only in the NGT group. After multivariate analyses, the strongest determinants of PAI-1 levels were BMI, FM, waist circumference, and high-density lipoprotein cholesterol in the NGT group and only HOMA IR in the IGT cohort. Discussion: This study demonstrates that PAI-1 concentrations are higher in IGT than in NGT subjects. Furthermore, we suggest that the influences of total adiposity, central fat, and insulin resistance, main determinants of PAI-1 concentrations, are different according to the degree of glucose tolerance.

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Among inflammation and coagulation markers, PAI-1 is a true component of the metabolic syndrome

Mertens

et al. 2006

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Objective: To investigate whether leukocyte count, fibrinogen, von Willebrand factor (vWF) and plasminogen activator inhibitor-1 activity (PAI-1) are increased in subjects with the metabolic syndrome as defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) and the World Health Organisation (WHO). Design: Cross-sectional study. Subjects: A total of 520 overweight and obese subjects: 379 women and 141 men, visiting the weight management clinic of a University Hospital. Subjects and measurements: Waist circumference, triglycerides, HDL cholesterol, blood pressure and fasting glucose were determined, and the presence or absence of the metabolic syndrome according to the NCEP-ATPIII criteria was assessed. In 349 subjects, data on the waist-to-hip ratio (WHR) and albumin excretion rate were available and the WHO criteria were applied. Insulin resistance was defined using the HOMA-IR index. Results: Subjects with the metabolic syndrome according to the NCEP-ATPIII criteria had significantly higher levels of leukocyte count (Po0.001) and PAI-1 (Po0.001), while no significant differences were found for fibrinogen or vWF (P40.05). Using the WHO criteria, similar results were found except for vWF, where higher levels were found in subjects with the metabolic syndrome. When subjects were classified according to the number of components of the metabolic syndrome, levels of leukocyte count, vWF and PAI-1 activity were significantly different (Po0.05). In logistic regression analysis PAI-1, gender and leukocyte count were independent determinants of the metabolic syndrome (Po0.001). Conclusion: Evidence for being a true component of the metabolic syndrome is strong for PAI-1, less for leukocyte count and weak for vWF and fibrinogen.

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Insulin Sensitivity and Hemostatic Factors in Clinically Healthy 58-year-old Men

Cited by 22 publications

References 21 publications

Abnormally high prevalence of major components of the metabolic syndrome in subjects with early-onset idiopathic venous thromboembolism

Abnormally high prevalence of major components of the metabolic syndrome in subjects with early-onset idiopathic venous thromboembolism

Effect of Glucose Tolerance Status on PAI‐1 Plasma Levels in Overweight and Obese Subjects

Among inflammation and coagulation markers, PAI-1 is a true component of the metabolic syndrome

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