LITTLE RELATIONSHIP OF PLASMINOGEN-ACTIVATOR INHIBITOR (PAI-1) WITH COMPLICATIONS OF INSULIN-DEPENDENT DIABETES-MELLITUS - PITTSBURGH EPIDEMIOLOGY OF DIABETES COMPLICATIONS STUDY

Objective: To examine the potential determinants of plasminogen activa tor inhibitor (PAI-1), the main regulatory component of the fibrinolyt ic process, and the relationship of PAI-1 with complications bf insuli n dependent diabetes mellitus (IDDM). Design: Cross-sectional study. S etting: Diabetes research center. Subjects: Individuals in this study were participants of the Epidemiology of Diabetes Complications study, a 10-year prospective study examining the prevalence, incidence, and interrelationships of the various complications of IDDM. Main Outcome Measures: Major complications of diabetes were assessed by standardize d procedures (i.e. retinopathy [fundus photography], neuropathy [based on Diabetes Control and Complications Trial protocol], nephropathy [e levated albumin excretion rate (>200 mu g/min)], coronary artery disea se [myocardial infarction/angina], lower extremity arterial disease [a nkle brachial index of <0.8 or amputation], Several metabolic paramete rs were also examined (e.g. glycosylated hemoglobin, lipid parameters, fibrinogen, and PAI-1 levels) in this study, Results: PAI-1 levels we re not found to be significantly increased with any specific IDDM comp lication, Modelling potential correlates in linear regression analyses where PAI-1 was the dependent variable revealed independent associate s with body mass index and triglycerides for males and age, fibrinogen , smoking history, and oral contraceptive use for females. Conclusions : The association of PAI-1 and other risk factors is complex with thes e data indicating an interdependent rather than an independent role fo r PAI-1 in IDDM complication development.