Comparison of Plasminogen Activator Inhibitor-1 Concentration in Insulin-Resistant Versus Insulin-Sensitive Healthy Women

Abstract

Abstract —The primary goal of this investigation was to see whether plasminogen activator inhibitor-1 (PAI-1) concentrations varied as a function of differences in insulin-mediated glucose disposal in 2 groups of healthy women matched for every other variable that might play a role in regulation of PAI-1. For this purpose, we recruited 32 healthy women, divided on the basis of their steady-state plasma glucose (SSPG) concentrations during the insulin suppression test into an insulin-resistant (SSPG=216±12 mg/dL, n=16) and an insulin-sensitive (94±6 mg/dL, n=16) group. PAI-1 antigen concentrations were significantly higher (26±4 versus 14±3 ng/mL, P <0.02) in the insulin-resistant group. In addition, fasting plasma insulin (18±3 versus 11±2 μU/mL, P <0.02) and triglyceride (160±19 versus 93±10 mg/dL, P <0.001) concentrations were higher in the insulin-resistant individuals, whereas HDL concentrations were lower (44±3 versus 58±3 mg/dL, P <0.005). However, the 2 groups were essentially identical in terms of age, menopausal status, hormone replacement therapy, body mass index (BMI), ratio of waist-to-hip girth, and blood pressure. When the experimental population was considered as 1 group, there were statistically significant correlations between PAI-1 antigen and the following variables: adjusting for differences in age and BMI, SSPG ( r =0.56, P <0.001); triglyceride ( r =0.39, P <0.05); and HDL cholesterol ( r =−0.65, P <0.001) concentrations. Finally, multiple regression analysis revealed the major determinants of PAI-1 to be insulin resistance, or insulin concentration, and HDL cholesterol. These results: 1) demonstrate that PAI-1 concentrations are higher in healthy, insulin-resistant women as compared with insulin-sensitive individuals, independent of differences in BMI or ratio of waist-to-hip girth; and 2) provide another mechanism by which insulin-resistant individuals are at increased thrombotic cardiovascular risk.