© 1997 American Heart Association, Inc.
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Gender Differences in the Relationships Between Plasma Plasminogen Activator Inhibitor-1 Activity and Factors Linked to the Insulin Resistance Syndrome in Essential Hypertension
From the Institutes of Clinical Medicine (I.T.), Community Medicine (K.H.B.), and Medical Biology (O.C.I.), University of Tromsø; the Department of Internal Medicine, Tromsø University Hospital (A.N., T.J.); and the Department of Clinical Chemistry, Aker Hospital, Oslo (K.I.B.), Norway.
Abstract Impaired fibrinolysis due to elevated levels of plasma plasminogen activator inhibitor type 1 (PAI-1) is a risk factor for thromboembolic disease. Hypertension, obesity, derangements in lipid and glucose homeostasis, and elevated levels of PAI-1 are features of the insulin resistance syndrome. The interrelationships between PAI-1 and the metabolic disturbances seen in this condition are unsettled. We investigated the associations between PAI-1 activity and components of the insulin resistance syndrome in 53 men and 31 women with untreated hypertension. In men, PAI-1 activity correlated significantly with plasma glucose (r=.41, P=.002), insulin sensitivity (r=-.35, P=.01), and insulin-induced suppression of nonesterified fatty acid (NEFA) (r=-.43, P=.007). Plasma glucose and NEFA suppression were independently associated with PAI-1 activity in a multivariate analysis. In women, PAI-1 activity correlated with body mass index (r=.62, P=.0005), waist-to-hip ratio (r=.75, P=.0001), plasma glucose (r=.50, P=.007), insulin (r=.49, P=.009), proinsulin (r=.57, P=.002), C-peptide (r=.60, P=.0009), insulin sensitivity (r=-.74, P=.0001), NEFA suppression (r=-.64, P=.003), and triglycerides (r=.58, P=.001). In multivariate analyses, insulin sensitivity and NEFA suppression were independently associated with PAI-1 if waist-to-hip ratio was not included in the model. After introduction of waist-to-hip ratio into the model, waist-to-hip ratio was the only independent predictor of PAI-1 activity. We conclude that in women, waist-to-hip ratio, body mass index, and insulin-induced NEFA suppression are determinants for PAI-1 activity. In men, insulin-induced NEFA suppression and plasma glucose are independently associated with PAI-1 activity.
Key Words: hypertension • plasminogen activator inhibitor-1 • insulin action • waist-to-hip ratio
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