1. Hypofibrinolytic State in Subjects with Type 2 Diabetes Mellitus Aggravated by the Metabolic Syndrome before Clinical Manifestations of Atherothrombotic Disease
- Author
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Manuel Martínez-Marino, Alfredo Leaños-Miranda, Eduardo Almeida-Gutiérrez, Jesús Hernández-Juárez, María Eugenia Galván-Plata, Elsa Aburto-Mejı́a, David Santiago-Germán, Antonio Alvarado-Moreno, Abraham Majluf-Cruz, Irma Isordia-Salas, and Mardia López-Alarcón
- Subjects
Male ,medicine.medical_specialty ,Article Subject ,Genotype ,medicine.medical_treatment ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Polymorphism, Single Nucleotide ,Gastroenterology ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Gene Frequency ,Polymorphism (computer science) ,Internal medicine ,Plasminogen Activator Inhibitor 1 ,Fibrinolysis ,medicine ,Humans ,Metabolic Syndrome ,General Immunology and Microbiology ,business.industry ,lcsh:R ,Type 2 Diabetes Mellitus ,Thrombosis ,General Medicine ,Middle Aged ,medicine.disease ,Endocrinology ,Diabetes Mellitus, Type 2 ,chemistry ,Plasminogen activator inhibitor-1 ,Female ,Metabolic syndrome ,business ,Plasminogen activator ,030217 neurology & neurosurgery ,Research Article - Abstract
Background. Metabolic and genetic factors induce plasminogen activator inhibitor type-1 (PAI-1) overexpression; higher PAI-1 levels decrease fibrinolysis and promote atherothrombosis.Aim. To assess PAI-1 antigen levels among subjects with type 2 diabetes mellitus (T2DM) plus Metabolic Syndrome (MetS) before clinical manifestations of atherothrombosis and the contribution of metabolic factors and 4G/5G polymorphism of PAI-1 gene on the variability of PAI-1.Methods. We conducted an observational, cross-sectional assay in a hospital in Mexico City from May 2010 to September 2011. MetS was defined by the International Diabetes Federation criteria. PAI-1 levels and 4G/5G polymorphism were determined by ELISA and PCR-RFLP analysis.Results. We enrolled 215 subjects with T2DM plus MetS and 307 controls. Subjects with T2DM plus MetS had higher PAI-1 levels than the reference group (58.4 ± 21 versus 49.9 ± 16 ng/mL,p=0.026). A model with components of MetS explained only 12% of variability on PAI-1 levels (R2= 0.12;p=0.001), withβ=0.18(p=0.03) for hypertension,β=-0.16(p=0.05) for NL HDL-c, andβ=0.15(p=0.05) for NL triglycerides.Conclusion. Subjects with T2DM plus MetS have elevated PAI-1 levels before clinical manifestations of atherothrombotic disease. Metabolic factors have a more important contribution than 4G/5G polymorphism on PAI-1 plasma variability.
- Published
- 2017