Insulin sensitivity and hemostatic factors in clinically healthy 58-year-old men

The objective of this cross-sectional study was to investigate the relation ship between factors of the coagulation- and fibrinolysis systems and insul in sensitivity in 104 clinically healthy, 58-years-old men. Insulin sensiti vity (hyperinsulinemic euglycemic clamp) adjusted for lean body mass, the m etabolic syndrome according to a suggested definition, and different factor s in the coagulation- and fibrinolysis system were determined. Subjects wit h the metabolic syndrome were characterised by increases in PAI-I activity, tPA antigen, protein C and protein S and low concentrations of tPA activit y, Insulin sensitivity was independently and reversibly associated with PAI -1 (p = 0.014) and directly with tPA activity (p = 0.001). Insulin sensitiv ity was also significantly negatively associated with protein S and protein C and several components in the metabolic syndrome, however not remaining: significant in multivariate analyses. Protein C and protein S were signifi cantly associated with PAI-1 activity, tPA activity (negatively), tPA antig en and antithrombin III. In conclusion, the data indicated that insulin res istance and several of the clustering components in the metabolic syndrome are accompanied by increased plasma concentrations of the anticoagulatory p roteins C and S which may represent a mechanism which counteracts the conco mitantly occurring hypofibrinolysis.