title: Plasminogen activator inhibitor 1 and insulin levels in various insulin resistance states.
abstract: Among obese insulin resistant subjects plasminogen activator inhibitor 1 (PAI 1) levels are closely associated with fasting insulin levels in cross sectional as well as intervention studies. Insulin concentration by itself does not seem to modulate PAI 1 levels at least in acute conditions. PAI 1 levels could be more directly related to the insulin resistant state than to hyperinsulinaemia. To elucidate further this phenomenon we compared insulin, triglyceride and PAI 1 levels in twenty control subjects and in three groups of patients presenting insulin resistance 14 obese subjects, 6 patients with Cushing disease and 7 with acromegaly. None of the tested subjects was diabetic. Fasting insulin levels were elevated in obese (21.4 +/- 8.0) hypercortisolic (20.3 +/- 11.0) and acromegalic patients (16.1 +/- 5.0) compared to controls (9.2 +/- 3.0 microU/ml, m +/- SD). PAI activity and PAI 1 antigen levels were elevated in the obese group only (34.3 +/- 13.0 for PAI 1 activity) and not in the others: 10.2 +/- 10.0, 7.0 +/- 4.6 I U/l for hypercortisolic and acromegalic patients respectively (normal controls 9.7 +/- 5.4). Triglyceride levels were also elevated among obese subjects 2.2 +/- 1.3 vs 1.1 +/- 0.4 mM/l in the controls; they were slightly higher than normal but not significantly in the hypercortisolic (1.5 +/- 0.6) and acromegalic (1.43 +/- 0.6 mM/l) patients. The mechanism of insulin resistance is different in the three conditions studied here. This may explain why elevated PAI 1 concentration are restricted to the common form of insulin resistance as seen in obese subjects. Therefore insulin resistant state per se is not associated with elevated PAI 1 levels.
authors.affiliation: Service de Diabétologie, Centre Hospitalo-Universitaire Timone, Marseille, France.
authors.forename: V
authors.initials: V
authors.lastname: Scelles
authors.forename: D
authors.initials: D
authors.lastname: Raccah
authors.forename: M C
authors.initials: MC
authors.lastname: Alessi
authors.forename: J M
authors.initials: JM
authors.lastname: Vialle
authors.forename: I
authors.initials: I
authors.lastname: Juhan-Vague
authors.forename: P
authors.initials: P
authors.lastname: Vague
mesh_terms: D000172:Acromegaly / Q000097:blood*; D000236:Adenoma / Q000097:blood*; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003480:Cushing Syndrome / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D009765:Obesity / Q000097:blood*; D010911:Pituitary Neoplasms / Q000097:blood*; D015849:Plasminogen Inactivators / Q000097:blood*; D012016:Reference Values; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D015849:Plasminogen Inactivators; D014280:Triglycerides