Plasma Plasminogen Activator Inhibitor-1 And Serum C Reactive Protein Levels In Subjects With Various Glucose Tolerances And Relations With Body Fat And Insulin

BackgroundType 2 diabetes (T₂DM) is a global health problem of increasing magnitude. Despite significant advances in strategies to delay the onset of diabetic complications, the disease is progressive and sequelae frequently develop over the course of the illness. Primary prevention thus remains a desirable goal. Accumulating evidence suggests that type 2 diabetes is associated with chronic low-grade inflammation. Cross-sectional studies have shown that concentrations of inflammatory markers are elevated in patients with type 2 diabetes and in those with metabolic syndrome. Abnormalities include definite increase of serum or plasma concentrations of several acute-phase proteins, including C-reactive protein (CRP), serum amyloid A, fibrinogen, α 1-acid glycoprotein and plasminogen activator inhibitor-1 (PAI-1). ObjectiveTo investigate the difference of plasma PAI-1 and serum C-reactive protein concentrations in subjects with various glucosetolerances and assess the relationship between plasminogen activator inhibitor-1, C-reactive protein and fat mass, blood glucose, fasting insulin, gender and age. Methods:Patients with type 2 diabetes (n=46) were recruited from the diabetes clinics at Tianjin Medical University General Hospital. A total of 150 volunteers were recruited by advertisement. According to oral 75g glucose tolerance test (OGTT), we choosed 50 subjects with normal glucose tolerance (NGT) and 69 cases with impaired glucose tolerance (IGT) .The plasma PAI-1 concentration was assayed by chromogenic method and the serum CRP concentration was detected with immunoscattering assay. Statistical analyses were performed with SPSS 11.0. Result1. The diabetic patients had significantly higher plasma PAI-1 and serum CRP than NGT and IGT. The plasma PAI-1 level was 0.69±0.08AU/ml in NGT subjects, 0.80±0.09AU/ml in IGT subjects, 0.84 + 0.08AU/ml in type 2 diabetes patients.(F=34.89, P<0.001). The serum CRP concentration [ median (25%,75%)] was 0.75 (0.50-1.20) mg/L in NGT, 2.00(1.30-2.60) mg/L in IGT, 3.70 C2.28-4.53) mg/L in type 2 diabetes patients (F=162.97, P<0.001) .The association of inflammatory markers with glucose tolerance remains significant after adjusting for body mass.2. After grouping the subjects according to BMI, the mean plasma PAI-1 and serum CRP levels are higher in obese subjects than in no-obese ones in NGT, IGT or type 2 diabetes.3. Dividing the subjects according to gender and age, PAI-1 level is lower in premenopause females than males in IGT and it has no association with gender and age in NGT and type 2 diabetes. Serum CRP is indicated to increase with age in NGT and it has no association with gender and age in IGT and type 2 diabetes.4. PAI-1 and log(CRP) show positive correlations with BMI, INS, circumstance and WHR and inverse correlations with ISI in NGT. Both PAI-1 and kg (CRP) are significantly correlated with BMI and INS in IGT and type 2 diabetes. There is no association between PAI-1 ,log(CRP) and blood glucose in all groups.5. The plasma PAI-1 concentration showed a tendency to increase with kg(CRP).