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Horm Metab Res 2001; 33(10): 602-607
DOI: 10.1055/s-2001-17907
Original Clinical
© Georg Thieme Verlag Stuttgart · New York

Visceral Fat is a Determinant of PAI-1 Activity in Diabetic and Non-Diabetic Overweight and Obese Women

I. Mertens1 , M. van der Planken2 , B. Corthouts3 , M. Wauters1 , F. Peiffer1 , I. De Leeuw1 , L. van Gaal1
  • 1 Department of Endocrinology, Metabolism and Clinical Nutrition, University Hospital Antwerp, Faculty of Medicine, University of Antwerp (UA), Belgium
  • 2 Department of Hematology, University Hospital Antwerp, Faculty of Medicine, University of Antwerp (UA), Belgium
  • 3 Department of Radiology, University Hospital Antwerp, Faculty of Medicine, University of Antwerp (UA), Belgium
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Publikationsdatum:
18. Oktober 2001 (online)

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Plasminogen activator inhibitor type 1 (PAI-1), an inhibitor of fibrinolysis and an important and independent cardiovascular risk factor, has been shown to be elevated in obesity and type 2 diabetes. Recent study results have suggested that adipose tissue - visceral fat in particular - could play an important role in the fibrinolytic process.

In order to assess the specific role of this fat distribution, we measured PAI-1 activity (AU/ml) and visceral fat (CT-scan at level L4-L5) in 2 groups of 30 overweight and obese diabetic and overweight and obese non-diabetic women. Subjects were matched for age, weight, body mass index, fat mass and total abdominal fat. Visceral adipose tissue and PAI-1 were significantly higher in diabetic women (p = 0.022 and p = 0.004 respectively) than in non-diabetic patients. Visceral fat correlated significantly with PAI-1 activity, even after correction for insulin and triglycerides (r = 0.28, p = 0.034). Stepwise regression analysis showed visceral fat as the most important determinant factor for PAI-1 in the whole group and in the non-diabetic group. In the diabetic group, fasting insulin was the most important determinant. These results show that visceral fat is more important than BMI or total body fat in the determination of PAI-1 levels. Furthermore, the increased amount of visceral fat in type 2 diabetics may contribute to the increase of PAI-1 activity levels and the subsequent increased risk for thrombovascular disease, regardless of BMI and total fatness.

Key words:

Fibrinolysis - Visceral Adipose Tissue - Obesity - Type 2 Diabetes

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Prof. Dr. L. Van Gaal

Department of Endocrinology,
Metabolism and Clinical Nutrition
University Hospital Antwerp

Wilrijkstraat 10
2650 Edegem-Antwerp
Belgium


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Fax: + 32 (3) 825-49-80

eMail: luc.van.gaal@uza.be