Metabolic factors, adipose tissue, and plasminogen activator inhibitor-1 levels in type 2 diabetes: findings from the look AHEAD study.
Metabolic factors, adipose tissue, and plasminogen activator inhibitor-1 levels in type 2 diabetes: findings from the look AHEAD study.
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DOI：
10.1161/atvbaha.111.224386
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发表时间：
2011-07
期刊：
影响因子：
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通讯作者：
Look Action for Health in Diabetes Research Group
中科院分区：
文献类型：
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作者：
Belalcazar LM;Ballantyne CM;Lang W;Haffner SM;Rushing J;Schwenke DC;Pi-Sunyer FX;Tracy RP;Look Action for Health in Diabetes Research Group
Plasminogen activator inhibitor-1 (PAI-1) production by adipose tissue is increased in obesity and its circulating levels are high in type 2 diabetes. PAI-1 increases cardiovascular risk by favoring clot stability and/or interfering with vascular remodeling. We investigated in obese diabetic persons whether an intensive lifestyle intervention for weight loss (ILI) would decrease PAI-1 levels independently of weight loss and whether PAI-1 reduction would be associated with changes in fibrinogen, an acute phase reactant, and/or fibrin fragment D-dimer (D-dimer), a marker of ambient coagulation balance. We examined 1-year changes in PAI-1, D-dimer and fibrinogen levels, adiposity, fitness, glucose and lipid control with ILI in 1,817 participants from Look AHEAD, a randomized trial investigating the effects of ILI, compared to usual care, on cardiovascular events in overweight/obese diabetic persons. Median PAI-1 levels decreased 29% with ILI, 2.5% with usual care (p<0.0001). Improvements in fitness, glucose control and HDL-cholesterol were associated with decreased PAI-1, independently of weight loss (p=0.03 for fitness, p<0.0001 for others). Fibrinogen and D-dimer remained unchanged. Reductions in PAI-1 levels with ILI in obese diabetic individuals may reflect an improvement in adipose tissue health that could impact cardiovascular risk without changing fibrinogen or D-dimer levels.
