Relationship between plasma plasminogen activator inhibitor 1 and insulin resistance

Diabetes Metab Res Rev. May-Jun 2000;16(3):192-201. doi: 10.1002/1520-7560(200005/06)16:3<192::aid-dmrr114>;2-g.


High plasminogen activator inhibitor 1 (PAI-1) levels are associated with an 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 the 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 proposed as a potentially important source of PAI-1 in humans. However, in light of recent studies, visceral adipose tissue appears to be involved in the increase of plasma PAI-1 via the metabolic disorders usually associated with central obesity, rather than directly. High plasma PAI-1 levels are undoubtedly related to insulin resistance, and the mechanisms which could explain such an increase in the Metabolic Syndrome appear to be multi-factorial and remain to be elucidated. These mechanisms may involve several metabolic disorders such as hyperinsulinemia, dyslipidemia, impaired glucose tolerance and hypertension, which would favor PAI-1 synthesis and release from different cell types.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / metabolism
  • Animals
  • Arteriosclerosis / blood
  • Blood Glucose / metabolism
  • Diabetes Mellitus / blood
  • Fatty Liver / blood
  • Fatty Liver / enzymology
  • Genetic Variation
  • Humans
  • Hyperlipidemias / blood
  • Hypertension / blood
  • Insulin / blood
  • Insulin Resistance / genetics
  • Insulin Resistance / physiology*
  • Plasminogen Activator Inhibitor 1 / blood*
  • Plasminogen Activator Inhibitor 1 / genetics
  • Plasminogen Activator Inhibitor 1 / metabolism
  • gamma-Glutamyltransferase / blood


  • Blood Glucose
  • Insulin
  • Plasminogen Activator Inhibitor 1
  • gamma-Glutamyltransferase