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A strong inverse relationship between PAI-1 and Lp(a) in hypertensive Type 2 diabetic patients
R Testa1, A R Bonfigli, C Sirolla
1Gerontological Research Department, Centre of Biochemistry, University of Ancona, Italy.
Insights
In diabetes and hypertension, reduced fibrinolysis is common. This study found a stronger inverse relationship between plasminogen activator inhibitor Type 1 (PAI-1) and lipoprotein(a) [Lp(a)] in hypertensive diabetics, suggesting a compensatory mechanism against vascular complications.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Hematology
Background:
- Thrombophilia and reduced fibrinolytic activity are observed in diabetes mellitus and hypertension.
- A prior study identified a relationship between plasminogen activator inhibitor Type 1 (PAI-1) and lipoprotein(a) [Lp(a)] in Type 2 diabetes mellitus patients.
- This relationship was hypothesized as a compensatory mechanism against hypofibrinolysis in Type 2 diabetes.
Purpose of the Study:
- To investigate the influence of concurrent hypertension and diabetes mellitus on plasma levels of PAI-1 and Lp(a).
- To examine other risk factors affecting fibrinolytic parameters in these patient groups.
- To explore the potential compensatory role of the PAI-1/Lp(a) relationship in mitigating vascular complications.
Main Methods:
- Study included four groups: non-hypertensive Type 2 diabetics, hypertensive Type 2 diabetics, non-diabetic hypertensives, and controls.
- Plasma concentrations of Lp(a), PAI-1 antigen and activity were measured.
- Parameters of oxidative, lipo-, and glycometabolic balance were assessed.
Main Results:
- Significant differences in triglycerides and antioxidant defense were found between diabetic and non-diabetic subjects (p<0.01).
- Analysis of variance indicated a statistically significant F test for Log PAI-1/Lp(a) (p = 0.02).
- Correlation analysis revealed a significant inverse relationship between Log PAI-1 antigen and Lp(a) in non-hypertensive diabetics (r = -0.38, p<0.01) and an even stronger correlation in hypertensive diabetics (r = -0.72, p<0.01).
Conclusions:
- The relationship between PAI-1 and Lp(a) is significantly influenced by the presence of both diabetes and hypertension.
- A stronger inverse correlation in hypertensive diabetics suggests a more pronounced compensatory mechanism.
- This PAI-1/Lp(a) interaction may play a crucial role in preventing vascular complications associated with diabetes and hypertension.
Abstract:
Thrombophilia with a contemporary reduction of fibrinolytic activity has been observed both in diabetes mellitus and hypertension. Previously, we found a relationship between plasminogen activator inhibitor Type 1 (PAI-1) and lipoprotein(a) [Lp(a)] in Type 2 diabetes mellitus patients without complications. We hypothesised that this relationship could be due to a compensatory mechanism able to lower the risk of hypofibrinolysis as found in Type 2 diabetes mellitus. The present work was aimed at investigating the influence of concurrent hypertension and diabetes mellitus on the plasma levels of these two fibrinolytic inhibitors. In addition, other risk factors, known to influence the fibrinolytic parameters, were taken into account. Forty-nine Type 2 nonhypertensive diabetic patients without complications, 47 Type 2 hypertensive diabetic patients without complications, 54 non-diabetic hypertensive subjects without complications as well as 87 control subjects were studied. Plasma concentrations of Lp(a), PAI-1 antigen and activity, and the main parameters of oxidative, lipo- and glycometabolic balance were determined. Significant statistical differences between diabetic and non-diabetic subjects were found concerning triglycerides and antioxidant defence (p<0.01). Analysis of variance showed the F test statistically significant in evaluating the Log PAI-1/Lp(a) (p = 0.02). Correlation analysis between Log PAI-1 antigen and Lp(a) was significant in non-hypertensive diabetic patients, as expected (r = -0.38, p<0.01), and even stronger in hypertensive diabetic patients (r = -O.72,p<0.01). These results allow to hypothesise that the relationship between PAI-1/Lp(a) could be determinant in avoiding vascular complications due to diabetes mellitus and hypertension.