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Plasminogen activator inhibitor-1, inflammation, obesity, insulin resistance and vascular risk
Open accessAbstract
Elevated plasma plasminogen activator inhibitor-1 (PAI-1) level is a core feature of insulin-resistance syndrome (IRS). Atherothrombotic complications in IRS are partly attributed to impaired fibrinolysis caused by increased plasma PAI-1 levels. Although the etiology of IRS is far from being explained, the clustering of inflammation, adipose tissue accumulation and insulin resistance suggests an etiopathological link. Proinflammatory cytokines might regulate PAI-1 expression in IRS; however, more studies are needed to confirm this complex mechanism in humans. Furthermore, modifying PAI-1 expression by PAI-1 inhibitors provides a new challenge and may reveal the true role of PAI-1 in atherosclerotic and insulin resistance processes.
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“Postprandial hyperglycaemia is also correlated with impaired myocardial perfusion in diabetic patients (658) .”
From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [658]
In the citing paper
“These include increased production of inflammatory cytokines, 35,36 plasminogen activator inhibitor-1, 37 and other bioactive products 38 -40 ; at the same time the potentially protective adipokine, adiponectin, is reduced.41,42”
From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [37]
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Gpr75 ‐deficient mice are protected from high‐fat diet–induced obesity
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Palella, E., Cimino, R., Pullano, S. A., Fiorillo, A. S., Gulletta, E., Brunetti, A., Foti, D. P., & Greco, M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010300 · Cited by 48
“Also, a link between PAI-1 and atherothrombosis via obesity and insulin resistance has been definitely assessed, being visceral fat a major regulator of PAI-1 [29,30].”
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“We also included inducible nitric oxide synthase (NOS2), an enzyme produced by classically activated macrophages (16) and plasminogen activator inhibitor 1 (PAI-1), a risk factor for cardiovascular disease that is elevated in humans in instances of acute inflammation (17) and the expression of which is increased by pr…”
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Jin, W., Olson, E. N., Moore, S. S., Basarab, J. A., Basu, U., & Guan, L. L. (2011) · Journal of Animal Science · doi:10.2527/jas.2011-4229 · Cited by 35
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“Plasminogen activator inhibitor-1 (PAI-1) is involved in fibrinolysis and its elevation thought to contribute to vascular disease and inflammation in obese states.(44,45) PAI-1 levels were reduced in the Rec2FGF21 group (Figure 5L), indicative of improved metabolic function and reduced inflammation.”
BackgroundHemostatic abnormalities associated with obesity and the metabolic syndrome
Reaven, G. M. (2005) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2005.01277.x · Cited by 35
von Känel, R., Loredo, J. S., Ancoli‐Israel, S., Mills, P. J., & Dimsdale, J. E. (2007) · Metabolism · doi:10.1016/j.metabol.2007.02.010 · Cited by 34
“These findings corroborate previous studies [1214,27-29] and are in agreement with the notion that elevated PAI-1 could contribute to increased atherothrombotic risk in OSA [9] and the metabolic syndrome [20].”
ResultChudý, P., Kotuličová, D., Staško, J., & Kubisz, P. (2011) · Blood Coagulation & Fibrinolysis · doi:10.1097/mbc.0b013e328346f8ca · Cited by 34
A Profibrotic Effect of Plasminogen Activator Inhibitor Type-1 (PAI-1) in the Heart
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“Conditions such as type 2 diabetes and insulin resistance accompanying obesity are associated with altered expression of plasminogen activator inhibitor type-1 (PAI1) in patients (1, 2) and in the hearts of mice subjected to myocardial infarction (MI) (3).”
BackgroundWaschki, B., Watz, H., Holz, O., MAGNUSSEN, H., Olejnicka, B. T., Welte, T., Rabe, K. F., & Janciauskiene, S. M. (2017) · International Journal of COPD · doi:10.2147/copd.s128689 · Cited by 33
“In addition, higher level of PAI-1 is associated with obesity, insulin resistance, diabetes, hyperlipidemia, and premature aging.(5,9,10) All these conditions are prevalent in COPD,(11,12) and a potential influence of PAI-1 on an enhanced thrombogenesis in COPD has been hypothesized.”
Somodi, S., Seres, I., Lőrincz, H., Harangi, M., Fülöp, P., & Paragh, G. (2018) · International Journal of Endocrinology · doi:10.1155/2018/9596054 · Cited by 33
Adipokines (adiponectin and plasminogen activator inhhibitor-1) in metabolic syndrome
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“[27,39,43,46] In univariate regression analysis, PAI-1 was positively associated with BMI, BFM and PBF, and negatively associated with BMR.”
MethodNutrition and hemostasis: A focus on urbanization in South Africa
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“In addition, we also demonstrated weak association between CEBPA 1558A and decreased PAI-1, an inhibitor of fibrinolysis which has been shown to be produced by adipocytes(56) and is associated with obesity and related metabolic abnormalities.(57) Recently Olofsson et al.”
BackgroundInsulin and glucose play a role in foam cell formation and function.
Shashkin, P. N., Jain, N., Miller, Y. I., Rissing, B. A., Huo, Y., Keller, S. R., Vandenhoff, G. E., Nadler, J. L., & McIntyre, T. M. (2006) · Cardiovascular Diabetology · doi:10.1186/1475-2840-5-13 · Cited by 32
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Hepatotoxicity due to tocilizumab and anakinra in rheumatoid arthritis: two case reports
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“Juhan-Vague et al have shown that an increase in PAI-1 levels are strongly associated with BMI, visceral fat, blood pressure, plasma levels of insulin or pro-insulin, triglycerides, small dense LDL particles, free fatty acids, and HDL cholesterol (Juhan-Vague et al., 2003).”
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“Plasma levels of PAI-1 are markedly elevated in obese individuals as well as in patients with insulin resistance, type 2 diabetes, and cardiovascular diseases hrough (CVDs) [15,16].”
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Metabolic Syndrome and Prediabetes
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“Additionally, impaired fibrinolysis caused by increased plasma plasminogen activator inhibitor-1 (PAI-1) levels is linked with insulin resistance that occurs with uremia and might be exacerbated in certain PD patients [27].”
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“Serpine1 encodes PAI-1, and elevated serum PAI-1 levels are strongly correlated with insulin resistance and liver steatosis [25].”
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“They are associated with visceral obesity, in both experimental animal models and humans [1, 12, 13], with insulin resistance [14] and with metabolic syndrome (MS) defined according to NCEP-ATPIII criteria [15].”
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Bowden, M. A., Tesch, G. H., Julius, T. L., Rosli, S., Love, J. E., & Ritchie, R. H. (2015) · Obesity · doi:10.1002/oby.21072 · Cited by 26
“PAI-I expression is reportedly increased in settings of T2DM (38); our data in diabetic myocardium is consistent with these prior observations.”
ResultPAI-1 and TNF-α profiles of adipose tissue in obese cardiovascular disease patients.
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“Thus, PAI-1 expression increases with insulin resistance and type 2 diabetes in patients (Juhan-Vague et al. 2003; McGill et al. 1994; Sobel et al. 1998) and in laboratory animals (Nordt et al. 1995).”
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“Systemic inflammation as presented in BD could increase PAI-1 levels [39,40].”
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“Several hemostatic alterations have been observed in obese individuals that can explain the thrombosis elevated risk such as altered fibrinolysis, increased plasminogen activator inhibitor (PAI-1), increased platelet aggregability, through elevations of von Willebrand factor, protein C resistance and higher levels of…”
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“PAI-1 is expressed by adipocytes, and its secretion is greater in the VAT relative to the SAT [53].”
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“with atherogenesis are fibrinogen and plasminogen activator inhibitor-1.(64) The latter is also associated with type 2 diabetes.”
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“The relationship between PAI-1 antigen, body constitution, plasma levels of tryglicerides and insulin is well established (38) and PAI-1 is therefore considered as a core feature of the insulin-resistance syndrome, also named metabolic syndrome (39).”
Metadata
- Authors
- Juhan-Vague, I., Alessi, M.-C., Mavri, A., & Morange, P. E.
- Affiliations
- Inserm (FR)
- Corresponding author
- Juhan-Vague, I.
- Venue
- Journal of Thrombosis and Haemostasis
- Publisher
- Elsevier BV
- Published
- 2003-07
- Volume
- 1
- Issue
- 7
- Pages
- 1575-1579
- ISSN
- 1538-7836 (ISSN-L)
- OpenAlex
- W2042742088
- Cited by
- 371
- References
- 95
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 13 · 2023: 8 · 2022: 14 · 2021: 6 · 2020: 11 · 2019: 14 · 2018: 10 · 2017: 17 · 2016: 9 · 2015: 19 · 2014: 14 · 2013: 11 · 2012: 13
- FWCI
- 4.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thrombosis and Haemostasis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Protease and Inhibitor Mechanisms
- Keywords
- plasminogen activator inhibitor-1, metabolic syndrome, inflammation, obesity, adipose tissue, inflammatory cytokines, impaired fibrinolysis, atherothrombosis, vascular risk, PAI-1 inhibitors, atherosclerosis
- MeSH terms
- Animals, Heart Diseases, Humans, Insulin Resistance, Obesity, Risk, Plasminogen Activator Inhibitor 1
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