title: Plasminogen activator inhibitor-1 (PAI-1) in children and adolescents with type 1 diabetes mellitus: relation to diabetic micro-vascular complications and carotid intima media thickness.
abstract: BACKGROUND
  Plasminogen activator inhibitor-1 (PAI-1) is a fast-acting inhibitor of fibrinolysis that has been linked to increase risk of thrombosis. We determined PAI-1 levels in 80 children and adolescents with type 1 diabetes (T1DM) compared with 40 healthy controls as a potential marker for micro-vascular complications and assessed the relation to carotid intima media thickness (CIMT) as a synergistic risk factor for development of atherosclerosis.
  
  
  METHODS
  Patients were divided into 2 groups according to micro-vascular complications. Hemoglobin A1c (HbA1c), urinary albumin excretion, fasting serum lipid profile and PAI-1 levels were measured. CIMT of the common carotid artery was assessed using high resolution ultrasonography.
  
  
  RESULTS
  PAI-1 levels were significantly elevated in the group with diabetes compared with control group (p<0.001). PAI-1 levels were also increased in patients with micro-vascular complications compared with those without (p<0.001). CIMT was significantly higher in patients, particularly those with micro-vascular complications than patients without complications or controls (p<0.001). Positive correlations were found between PAI-1 levels and random blood glucose, HbA1c, triglycerides, total cholesterol and CIMT (p<0.05).
  
  
  CONCLUSIONS
  Increased plasma PAI-1 may be involved in the state of hypofibrinolysis in patients with T1DM leading to the occurrence of micro-vascular complications and increased risk of atherosclerosis.
authors.affiliation: Diabetes and Endocrinology Unit, Department of Pediatrics, Faculty of medicine, Ain shams University, Cairo, Egypt. Electronic address: amiradiabetes@yahoo.com.
authors.forename: Amira Abdel Moneam
authors.initials: AA
authors.lastname: Adly
authors.affiliation: Diabetes and Endocrinology Unit, Department of Pediatrics, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Nancy Samir
authors.initials: NS
authors.lastname: Elbarbary
authors.affiliation: Department of Clinical Pathology, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Eman Abdel Rahman
authors.initials: EA
authors.lastname: Ismail
authors.affiliation: Diabetes and Endocrinology Unit, Department of Pediatrics, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Samar Reda
authors.initials: SR
authors.lastname: Hassan
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000652:urine; D050197:Atherosclerosis / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D055806:Microvessels / Q000473:pathology*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids; D017395:Plasminogen Activator Inhibitor 1
keywords: Carotid intima media thickness; Micro-vascular complications; Plasminogen activator inhibitor-1; Type 1 diabetes