title: Low PAI-1 activity in relation to inflammatory parameters, insulin profile and body mass index.
abstract: OBJECTIVE
  High plasminogen activator inhibitor type 1 (PAI-1) activity is associated with inflammatory reactions and insulin resistance, but it is unclear what regulates PAI-1 activity at the low end. The purpose of this study was to investigate if patients with low PAI-1 activity have a lack of inflammatory response or a low insulin level.
  
  
  METHODS
  Retrospective cohort study with internal controls.
  
  
  METHODS
  Sixty-three patients referred for investigation of bleeding tendency and with low PAI-1 activity were compared with 118 patients with normal or high PAI-1 activity.
  
  
  RESULTS
  Levels of C-peptide, proinsulin, high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6). Adjustments were made for body mass index (BMI), oral oestrogens and age. Low PAI-1 activity was defined as less than 1 U mL(-1).
  
  
  RESULTS
  Body mass index in the low normal range, oral oestrogens, young age and low C-peptide were significantly associated with low PAI-1 activity and there was a trend for association with IL-6 in univariable analysis. The effect of age disappeared after correction for oral oestrogens and the effect of C-peptide and IL-6 disappeared after further adjustments. Low BMI remained as the strongest predictor of low PAI-1 activity.
  
  
  CONCLUSIONS
  Patients with bleeding tendency and low PAI-1 activity have inflammatory and insulin profiles similar to those with normal or high PAI-1, whereas BMI seems to be the most important determinant.
authors.affiliation: Department of Medicine, Karolinska Institute, Stockholm, Sweden. anna.agren@karolinska.se
authors.forename: A
authors.initials: A
authors.lastname: Agren
authors.forename: B
authors.initials: B
authors.lastname: Wiman
authors.forename: S
authors.initials: S
authors.lastname: Schulman
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D005260:Female; D006470:Hemorrhage / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011384:Proinsulin / Q000097:blood; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002096:C-Peptide; D007328:Insulin; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; D002097:C-Reactive Protein; D011384:Proinsulin