Relationship between plasminogen activator inhibitor type-1 plasma levels and the lipoprotein(a) concentrations in non-insulin-dependent diabetes mellitus

• Published in: Diabetes research and clinical practice Vol. 33; no. 2; pp. 111 - 118
• Main Authors: Testa, R., Bonfigli, A.R., Piantanelli, L., Manfrini, S., Testa, I., Gregorio, F.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01-07-1996; Elsevier Science
• Subjects: Aged; Biological and medical sciences; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fibrinolysis; Humans; Hypoglycemic Agents - pharmacology; Hypoglycemic Agents - therapeutic use; Linear Models; Lipoprotein(a); Lipoprotein(a) - blood; Lipoprotein(a) - drug effects; Male; Medical sciences; Metformin - pharmacology; Metformin - therapeutic use; Middle Aged; Non-insulin-dependent diabetes mellitus; Plasminogen Activator Inhibitor 1 - blood; Plasminogen Activator Inhibitor 1 - metabolism; Plasminogen activator inhibitor type 1; Serine Proteinase Inhibitors - blood; Serine Proteinase Inhibitors - metabolism; Lipoprotein(a); Plasminogen activator inhibitor type 1; Non-insulin-dependent diabetes mellitus; Fibrinolysis; Endocrinopathy; Human; u-Plasminogen activator; Serine endopeptidases; Enzyme; Plasminogen activator inhibitor type I; Non insulin dependent diabetes; t-Plasminogen activator; a Lipoprotein; Blood plasma; Antigen; Hydrolases; Inhibitor; Proteinases
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/0168-8227(96)01286-7

The first part of the paper deals with the relationship between two inhibiting factors of the complex enzyme cascade regulating fibrinolysis, namely plasminogen activator inhibitor type-1 (PAI-1) and lipoprotein(a) (Lp(a)). Blood concentrations of Lp(a), PAI-1 antigen (PAI-1 AG) and activity (PAI-1 AT), and the main parameters of lipo- and glyco-metabolic balance were studied in 80 type II diabetic patients. Roughly hyperbolic patterns have been found between PAI-1 and Lp(a). Negative statistically significant linear correlation can be elicited when Log PAI-1 AG and Log PAI-1 AT values are plotted versus Lp(a) values, the first one being particularly tight. These findings suggest a nearly on/off control of the two parameters, limiting the risk of hypofibrinolysis. The second part of the paper was aimed at verifying this hypothesis. A group of 30 diabetic patients were treated for 3 months with metformin, an antidiabetic biguanide compound which has been reported to reduce PAI-1 levels both in diabetic and in non-diabetic patients. Metformin significantly reduced PAI-1 AG and PAI-1 AT but did not influence plasma Lp(a) levels. A clear linear correlation between the basal Lp(a) values and the changes in PAI-1 AG levels was found. An even tighter correlation was elicited between the decrease in PAI-1, and PAI-1 pretreatment values.