Plasminogen activator inhibitor type 1 (PAI-1), an inhibitor of fibrinolysis and an
important and independent cardiovascular risk factor, has been shown to be elevated
in obesity and type 2 diabetes. Recent study results have suggested that adipose tissue
- visceral fat in particular - could play an important role in the fibrinolytic process.
In order to assess the specific role of this fat distribution, we measured PAI-1 activity
(AU/ml) and visceral fat (CT-scan at level L4-L5) in 2 groups of 30 overweight and
obese diabetic and overweight and obese non-diabetic women. Subjects were matched
for age, weight, body mass index, fat mass and total abdominal fat. Visceral adipose
tissue and PAI-1 were significantly higher in diabetic women (p = 0.022 and p = 0.004
respectively) than in non-diabetic patients. Visceral fat correlated significantly
with PAI-1 activity, even after correction for insulin and triglycerides (r = 0.28,
p = 0.034). Stepwise regression analysis showed visceral fat as the most important
determinant factor for PAI-1 in the whole group and in the non-diabetic group. In
the diabetic group, fasting insulin was the most important determinant. These results
show that visceral fat is more important than BMI or total body fat in the determination
of PAI-1 levels. Furthermore, the increased amount of visceral fat in type 2 diabetics
may contribute to the increase of PAI-1 activity levels and the subsequent increased
risk for thrombovascular disease, regardless of BMI and total fatness.
Key words:
Fibrinolysis - Visceral Adipose Tissue - Obesity - Type 2 Diabetes
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1361-1365
luc.van.gaal@uza.be
