title: Plasminogen activator inhitor-1 associates with cardiovascular risk factors in healthy young adults in the Cardiovascular Risk in Young Finns Study.
abstract: OBJECTIVE
  Hypofibrinolysis displayed by elevated serum plasminogen activator inhibitor 1 (PAI-1) level has been associated with cardiovascular disease (CVD) and its risk factors such as obesity and insulin resistance. However, no studies have examined associations between PAI-1 and CVD risk factors in healthy subjects. We examined associations between serum PAI-1, ultrasound markers of atherosclerosis and CVD risk factors and whether PAI-1 improves prediction of atherosclerosis over known risk factors in a cohort of asymptomatic adults.
  
  
  METHODS
  We analyzed PAI-1 and CVD risk factors and assessed carotid intima-media thickness (cIMT), distensibility (CDist) and the presence of a carotid atherosclerotic plaque and flow-mediated dilation (FMD) ultrasonographically for 2202 adults (993 men and 1,209 women, aged 30-45 years) participating in the ongoing longitudinal cohort study, The Cardiovascular Risk in Young Finns Study. High cIMT was defined as >90th percentile and/or carotid plaque and low CDist and low FMD as <20th percentile.
  
  
  RESULTS
  In bivariate analyses, PAI-1 correlated directly with cIMT and the risk factors: blood pressure, BMI, waist and hip circumference, alcohol use, total and LDL-cholesterol, triglycerides, glomerular filtration rate, high-sensitivity CRP and glucose (all P<0.005). PAI-1 was higher in men and increased with age. Inverse correlation was observed with CDist, HDL-cholesterol and adiponectin in both sexes, with testosterone and sex hormone binding globulin in men and with creatinine and oral contraceptive use in women (P<0.005). Independent direct associations were observed between PAI-1 and waist circumference, serum triglycerides, insulin, alcohol use and age and inverse with serum creatinine, HDL-cholesterol and adiponectin. PAI-1 did not improve estimation of high cIMT, low CDist and low FMD over conventional risk factors (P for difference in area under curve ≥ 0.37).
  
  
  CONCLUSIONS
  PAI-1 was independently associated with several known CVD risk factors, especially obesity markers, in both men and women. However, addition of PAI-1 to known risk factors did not improve cross-sectional prediction of high cIMT, low CDist and low FMD suggesting that PAI-1 is not a clinically important biomarker in early atherosclerosis.
authors: The Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. juho.raiko@utu.fi
authors: Juho R H
authors: JR
authors: Raiko
authors: Mervi
authors: M
authors: Oikonen
authors: Maria
authors: M
authors: Wendelin-Saarenhovi
authors: Niina
authors: N
authors: Siitonen
authors: Mika
authors: M
authors: Kähönen
authors: Terho
authors: T
authors: Lehtimäki
authors: Jorma
authors: J
authors: Viikari
authors: Antti
authors: A
authors: Jula
authors: Britt-Marie
authors: BM
authors: Loo
authors: Risto
authors: R
authors: Huupponen
authors: Liisa
authors: L
authors: Saarikoski
authors: Markus
authors: M
authors: Juonala
authors: Olli T
authors: OT
authors: Raitakari
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D017395:Plasminogen Activator Inhibitor 1