Improved fibrinolysis by an intensive lifestyle intervention in subjects with impaired glucose tolerance. The Finnish Diabetes Prevention Study

Diabetologia. 2005 Nov;48(11):2248-53. doi: 10.1007/s00125-005-1938-5. Epub 2005 Oct 5.


Aims/hypothesis: The aim of this study was to investigate the effects of lifestyle intervention on the levels of plasminogen activator inhibitor (PAI-1) and fibrinogen in subjects participating in the Finnish Diabetes Prevention Study (DPS).

Methods: In five DPS centres, 321 subjects with impaired glucose tolerance (intervention group, n=163; control group, n=158) had their PAI-1 and fibrinogen levels measured at baseline and at the 1-year follow-up. Additional 3-year follow-up assessments were carried out in a sample of 97 subjects in one of the DPS centres (Turku). The intervention programme included an intensive lifestyle intervention aiming at weight reduction, healthy diet and increased physical activity.

Results: During the first intervention year, PAI-1 decreased by 31% in the intervention group but showed no change in the control group (p<0.0001). In the Turku subgroup, the decrease in PAI-1 persisted throughout the 3-year follow-up. Changes in PAI-1 were associated with the number of lifestyle changes made during the first year (p=0.008). Weight reduction was the most important factor explaining the decrease in PAI-1. Changes in fibrinogen levels did not differ between the groups.

Conclusions/interpretation: In addition to the previously reported reduction in the risk of type 2 diabetes in DPS participants with impaired glucose tolerance, the intensive dietary and exercise intervention had beneficial long-term effects on fibrinolysis as indicated by the reduced levels of PAI-1. These results suggest that elevated PAI-1 levels in obese subjects with impaired glucose tolerance are mostly reversible by lifestyle changes, especially those geared to weight reduction.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diabetes Mellitus / prevention & control*
  • Diabetes Mellitus, Type 2 / prevention & control
  • Diet
  • Exercise
  • Female
  • Fibrinogen / metabolism
  • Fibrinolysis
  • Finland
  • Follow-Up Studies
  • Glucose Intolerance / metabolism*
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Plasminogen Activator Inhibitor 1 / blood
  • Weight Loss


  • Plasminogen Activator Inhibitor 1
  • SERPINE1 protein, human
  • Fibrinogen