Increased plasma plasminogen activator inhibitor 1 levels. A possible link between insulin resistance and atherothrombosis
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TLDR
The increase in plasma plasminogen activator inhibitor 1 levels linked to hyperinsulinaemia is a tempting partial explanation for the association between insulin resistance and coronary disease.Abstract:
According to recent prospective studies, hypofibrinolysis due to elevated plasma plasminogen activator inhibitor 1 levels appears to be an independent risk factor for myocardial reinfarction in men, and hyperinsulinaemia, a major indicator of insulin resistance is considered as a risk factor for coronary disease. It has recently been shown that insulin resistance is accompanied by an increased plasma plasminogen activator inhibitor 1 concentration: A significant correlation coefficient was demonstrated between plasminogen activator inhibitor 1 and fasting plasma insulin in the normal population, in obese subjects, in Type 2 (non-insulin-dependent) diabetic patients and in angina pectoris. Attempts to decrease insulin resistance such as fasting, diet, or administration of an oral anti-diabetic drug such as Metformin induced a parallel decrease in plasma insulin and plasminogen activator inhibitor 1 levels. This inhibitor is produced by endothelial cells and by hepatocytes in culture. Plasminogen activator inhibitor 1 synthesis by hepatocytes in culture was stimulated by an increasing insulin concentration, or low density lipoproteins, whereas the endothelial cell synthesis was stimulated by very low density lipoproteins especially when they were obtained from hypertriglyceridaemic patients. Therefore, a direct effect of insulin or lipoprotein changes on the cells which synthesize plasminogen activator inhibitor 1 could be responsible for its increased plasma concentration in insulin resistance states. The increase in plasma plasminogen activator inhibitor 1 levels linked to hyperinsulinaemia is a tempting partial explanation for the association between insulin resistance and coronary disease.read more
Citations
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Journal ArticleDOI
Hyperinsulinemia as an Independent Risk Factor for Ischemic Heart Disease
Jean-Pierre Després,Benoît Lamarche,Pascale Mauriège,Bernard Cantin,Gilles R. Dagenais,Sital Moorjani,Paul-J. Lupien +6 more
TL;DR: High fasting insulin concentrations appear to be an independent predictor of ischemic heart disease in men after adjustment for other risk factors.
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Insulin resistance and cardiovascular disease
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Role of Insulin Resistance in Human Disease (Syndrome X): An Expanded Definition
TL;DR: It seems likely that the cluster of changes associated with resistance to insulin-mediated glucose uptake comprise a syndrome, which plays an important role in the etiology and clinical course of patients with non-insulin-dependent diabetes, high blood pressure, and coronary heart disease.
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Plasminogen-activator inhibitor type 1 and coronary artery disease.
Hans P. Kohler,Peter J. Grant +1 more
TL;DR: The development of coronary artery disease, and specifically myocardial infarction, involves hyperplasia of arterial smooth muscle, the development of fatty streaks, atheroma formation, plaque rupture, and ultimately thrombus formation and vessel occlusion.
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Adipokines: The missing link between insulin resistance and obesity
TL;DR: White adipose tissue was believed to be just an energy-storage organ, but it is now recognized to be an active participant in energy homoeostasis and physiological functions such as immunity and inflammation.
References
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