Increased Plasminogen Activator Inhibitor Activity in Non Insulin Dependent Diabetic Patients – Relationship with Plasma Insulin
Increased Plasminogen Activator Inhibitor Activity in Non Insulin Dependent Diabetic Patients – Relationship with Plasma Insulin
复制标题
非胰岛素依赖型糖尿病患者纤溶酶原激活剂抑制剂活性增加——与血浆胰岛素的关系
作者：
I. Juhan;C. Roul;M. Alessi;J. Ardissone;M. Heim;P. Vague
已知2型糖尿病患者经常具有高胰岛素水平，并且最近被描述为与正常对照相比具有高纤溶酶原激活物抑制剂（派）活性。我们研究了38例2型糖尿病患者血浆派活性与胰岛素及其它指标的关系。与正常对照组相比，糖尿病患者派活性、血糖、胰岛素、甘油三酯、胆固醇和载脂蛋白B水平均升高，其中合并冠心病的糖尿病患者PAI活性最高。派活性与胰岛素（r = 0.60，p <0.001）、体重指数（r = 0.32，p <0.05）和载脂蛋白B（r = 0.33，p <0.05）呈显著相关。后两种相关性在调整胰岛素后消失。这些结果与我们先前的报告一致，显示胰岛素对肝细胞系合成派的体外作用。2型糖尿病患者的高胰岛素血症可增加肝脏派的合成，导致纤溶功能低下，这可能在血管并发症的发生中起作用。试图减少高胰岛素血症可能有一个有利的影响，降低派活性。
Summary Type 2 diabetic patients are known to frequently have a high insulin level and were recently described as having high plasminogen activator inhibitor (PAI) activity, compared to normal controls. As we have shown in several clinical conditions (normal subjects, obese patients, angina pectoris patients) that plasma PAI activity was linked with plasma insulin, we have studied in 38 type 2 diabetic patients the relationship between PAI activity, insulin and other parameters. Patients showed higher level of PAI activity, as well as plasma glucose, insulin, triglyceride, cholesterol and Apolipoprotein B levels than normal controls; highest values were observed with diabetic patients also affected by coronary artery disease. A significant correlation was found between PAI activity and insulin (r = 0.60, p <0.001), body mass index (r = 0.32, p <0.05) and Apolipoprotein B (r = 0.33, p <0.05). The two latter correlations disappeared after adjustment for insulin. These results are in agreement with our previous report showing an in vitro effect of insulin on the synthesis of PAI by a hepatocellular cell line. Hyperinsulinemia presented by type 2 diabetic patients may increase the hepatic synthesis of PAI, inducing an hypofibrinolysis, which could play a role in the development of the vascular complications. Attempts to reduce hyperinsulinemia could have a favorable effect by lowering PAI activity.