Research on the correlation of serum plasminogen activator inhibitor-1 level to vascular complications in type 2 diabetes mellitus patients with overweight or obesity

Abstract

Objective: To explore the relationship between serum plasminogen activator inhibitor (PAI-1) level and Type 2 Diabetes Mellitus (T2DM) accompanied by overweight or obesity by observing not only the changes of PAI-1 level in T2DM patients with overweight or obesity, but also glucose and lipid metabolism related indicators, the changes of the inflammatory cytokines secreted by adipocytes, and then making an analysis on the correlation to PAI-1.

Methods: 36 cases of healthy examinees were selected as normal control group (NC group), and the experimental group can be divided into T2DM group (54 cases), Overweight/Obesity group (35 cases) and T2DM + Overweight/Obesity group (48 cases). Glucose and lipid metabolism related indicators such as fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c), fasting insulin (FINS), insulin resistance index (IR), body weight index (BMI) and inflammatory cytokines (interleukin-6 (IL-6), tumor necrosis factor (TNF-α) and PAI-1 were observed and compared between groups, and then made an analysis to explore the correlation of these factors to PAI-1.

Results: (1) Compared with NC group, the levels of FBG, HbA1c, FINS and IR were increased in T2DM group, and the difference was of statistical significance. However, there was no statistically significant difference in TG, TC, LDL-C and BMI between NC group and T2DM group; the levels of FINS, IR, TG, LDL-C, TC and BMI were elevated in Overweight/Obesity group, and the difference was of statistical significance. However, there was no statistically significant difference in FBG and HbA1c; the levels of FBG, HbA1c, FINS, IR, TG, LDL-C, TC and BMI were up-regulated in T2DM + Overweight/Obesity group, and the difference was of statistical significance. Compared with T2DM group, the levels of TG, TC, LDL-C and BMI were increased in Overweight/Obesity group, and the difference was of statistical significance, however, the levels of FBG, HbA1c, FINS and IR were decreased, and the difference was statistically significant; The levels of FINS, IR, TG, TC, LDL-C and BMI were elevated in T2DM + Overweight/Obesity group, and the difference was of statistical significance, however, there was no statistically significant difference in FBG and HbA1c. Compared with Overweight/Obesity group, the levels of FBG, FINS, IR, HbA1c and LDL-C were increased in T2DM + Overweight/Obesity group, and the difference was of statistical significance. However, the difference in TG, TC and BMI was not statistically significant. (2) Compared with NC group, the levels of IL-6, TNF-α and PAI-1 were increased in T2DM group, Overweight/Obesity group and T2DM + Overweight/Obesity group, and the difference was statistically significant. Compared with T2DM group, the levels of IL-6 and TNF-α were elevated in Overweight/Obesity group, and the difference was of statistical significance, but there was no statistically significant difference in PAI-1; the levels of IL-6, TNF-α and PAI-1 were up-regulated in T2DM + Overweight/Obesity group, and the difference was statistically significant. Compared with Overweight/Obesity group, there was no statistically significant difference in IL-6 and TNF-α between T2DM + Overweight/Obesity group and Overweight/Obesity group, but the level of PAI-1 was increased in T2DM + Overweight/Obesity group, and the difference was of statistical significance. (3) Multivariate Logistic Regression Analysis showed that HbA1c, IR, TG, BMI, IL-6 and TNF-α were independently associated with the level of PAI-1 (all p < .05).

Conclusions: (1) The level of PAI-1 is higher in type 2 diabetes mellitus patients with overweight or obesity than that in patients only with type 2 diabetes mellitus, and it is one of causes that result in vascular complications. (2) The increase in the level of PAI-1 is considered to be associated with IL-6 and TNF-α secreted by adipocytes.