Relationship between plasma plasminogen activator inhibitor 1 and insulin resistance

High plasminogen activator inhibitor 1 (PAI-1) levels are associated with a n increased cardiovascular risk of atherothrombosis. Furthermore, increased plasma PAI-1 levels are associated with dyslipidemia, hyperinsulinemia and hypertension. This association between PAI-1 and metabolic components of t he Metabolic Syndrome could explain the predisposition of insulin resistant patients to atherothrombosis. Recent studies have suggested that visceral adipose tissue might be the link between elevated plasma PAI-1 and insulin resistance in the Metabolic Syndrome. Indeed, visceral adipose tissue was p roposed as a potentially important source of PAI-1 in humans. However, in l ight of recent studies, visceral adipose tissue appears to be involved in t he increase of plasma PAI-1 via the metabolic disorders usually associated with central obesity, rather than directly. High plasma PAI-1 levels are un doubtedly related to insulin resistance, and the mechanisms which could exp lain such an increase in the Metabolic Syndrome appear to be multifactorial and remain to be elucidated. These mechanisms may involve several metaboli c disorders such as hyperinsulinemia, dyslipidemia, impaired glucose tolera nce and hypertension, which would favor PAI-1 synthesis and release from di fferent cell types. Copyright (C) 2000 John Wiley & Sons, Ltd.