PLASMINOGEN-ACTIVATOR INHIBITOR ACTIVITY IN VARIOUS TYPES OF ENDOGENOUS HYPERTRIGLYCERIDEMIA

In various groups of patients, plasminogen activator inhibitor (PAI), plasma insulin and triglyceride level are closely associated all toget her. To clarify this relationship we looked at PAI activity in patient s with endogenous hypertriglyceridemia, 15 were obese (body mass index (BMI) higher than 27, mean: 36.2), 9 had a strictly normal weight (BM I lower than 25, mean: 22.8) and 11 had alcohol induced hypertriglycer idemia. They were compared to 20 control subjects of normal weight and with plasma triglyceride level lower than 1. 7 mmol/l and 11 hypercho lesterolemic patients. Overall mean PAI levels in hypertriglyceridemic patients were higher than in controls and hypercholesterolemic subjec ts. Compared to controls (mean+/-SD PAI: 9.8+/-5.4 U/ml), both PAI act ivity (30+/-12 U/ml p<0.05) and plasma insulin were elevated in obese hypertriglyceridemic patients but not different from normal in the nor mal weight hypertriglyceridemic patients (PAI activity 15.2+/-4.1 U/ml ns). In alcoholic hypertriglyceridemic patients, PAI activity was ele vated (21+/-9.7 U/ml p<0.05) but insulin was normal. In the whole seri es PAI activity was weekly correlated with triglyceride level (r=0.295 p<0.05), but in strong positive relationship with insulin levels (r=0 .572 p<0.0001). These results suggest that in obese patients insulin r esistance is the common cause of both hypertriglyceridemia and elevati on of PAI activity. Other mechanisms have to be looked for in some con ditions such as alcohol associated hypertriglyceridemia. Endogenous hy pertriglyceridemia occurring in strictly normal weight subjects is not accompanied by elevated PAI levels.