Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus

Abstract Aims Plasminogen activator inhibitor-1 (PAI-1) is the main inhibitor of the fibrinolytic system and is mainly secreted from adipose tissue. It is associated with cardiovascular disease and has also been considered a possible early risk marker for type 2 diabetes. Here, we present the result...

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Main Authors: Jenny Hernestål-Boman, Tina Öhman, Jan-Håkan Jansson, Marcus M. Lind, Olov Rolandsson, Ingvar A. Bergdahl, Lars Johansson
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01629-4
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author Jenny Hernestål-Boman
Tina Öhman
Jan-Håkan Jansson
Marcus M. Lind
Olov Rolandsson
Ingvar A. Bergdahl
Lars Johansson
author_facet Jenny Hernestål-Boman
Tina Öhman
Jan-Håkan Jansson
Marcus M. Lind
Olov Rolandsson
Ingvar A. Bergdahl
Lars Johansson
author_sort Jenny Hernestål-Boman
collection DOAJ
description Abstract Aims Plasminogen activator inhibitor-1 (PAI-1) is the main inhibitor of the fibrinolytic system and is mainly secreted from adipose tissue. It is associated with cardiovascular disease and has also been considered a possible early risk marker for type 2 diabetes. Here, we present the results of a large prospective study investigating PAI-1 levels in relation to incident type 2 diabetes mellitus. Methods We conducted a prospective incident case-referent study within the Västerbotten Intervention Programme (VIP). Data on cardiovascular risk factors, fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hPG) were collected at baseline health examination 1990–2005. Blood samples were collected and stored for future analyses. Participants were followed and 484 cases developed type 2 diabetes. Referents without type 2 diabetes were matched for sex, age, and year of participation, n = 484. Baseline plasma samples were analysed for PAI-1. Subgroup analysis was performed for 201 cases and 201 matched referents with normal baseline glucose levels (FPG < 6.1 and 2hPG < 8.9 mmol/L). Results Elevated baseline levels of PAI-1 were associated with incident type 2 diabetes after adjustments for BMI, family history of diabetes, smoking status, hypertension, FPG and 2hPG (PAI-1; OR = 1.87, 95% CI: 1.06–3.29). A similar result was shown in the subgroup analysis with 201 participants who had normal glucose levels at time of the health examination (PAI-1; OR = 2.68, 95% CI: 1.03–6.95). Conclusions Elevated PAI-1 levels in non-diabetic persons precede the manifestation of type 2 diabetes and can be detected before an elevation of FPG or 2-hPG is observed.
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spelling doaj-art-235d1dbafb5e4f55a21036b33119e85c2025-08-20T03:10:50ZengBMCDiabetology & Metabolic Syndrome1758-59962025-02-011711610.1186/s13098-025-01629-4Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitusJenny Hernestål-Boman0Tina Öhman1Jan-Håkan Jansson2Marcus M. Lind3Olov Rolandsson4Ingvar A. Bergdahl5Lars Johansson6Department of Laboratory Medicine, University Hospital of UmeåDepartment of Public Health and Clinical Medicine, Umeå UniversityDepartment of Public Health and Clinical Medicine, Umeå UniversityDepartment of Public Health and Clinical Medicine, Umeå UniversityDepartment of Public Health and Clinical Medicine, Umeå UniversityDepartment of Public Health and Clinical Medicine, Umeå UniversityDepartment of Public Health and Clinical Medicine, Umeå UniversityAbstract Aims Plasminogen activator inhibitor-1 (PAI-1) is the main inhibitor of the fibrinolytic system and is mainly secreted from adipose tissue. It is associated with cardiovascular disease and has also been considered a possible early risk marker for type 2 diabetes. Here, we present the results of a large prospective study investigating PAI-1 levels in relation to incident type 2 diabetes mellitus. Methods We conducted a prospective incident case-referent study within the Västerbotten Intervention Programme (VIP). Data on cardiovascular risk factors, fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hPG) were collected at baseline health examination 1990–2005. Blood samples were collected and stored for future analyses. Participants were followed and 484 cases developed type 2 diabetes. Referents without type 2 diabetes were matched for sex, age, and year of participation, n = 484. Baseline plasma samples were analysed for PAI-1. Subgroup analysis was performed for 201 cases and 201 matched referents with normal baseline glucose levels (FPG < 6.1 and 2hPG < 8.9 mmol/L). Results Elevated baseline levels of PAI-1 were associated with incident type 2 diabetes after adjustments for BMI, family history of diabetes, smoking status, hypertension, FPG and 2hPG (PAI-1; OR = 1.87, 95% CI: 1.06–3.29). A similar result was shown in the subgroup analysis with 201 participants who had normal glucose levels at time of the health examination (PAI-1; OR = 2.68, 95% CI: 1.03–6.95). Conclusions Elevated PAI-1 levels in non-diabetic persons precede the manifestation of type 2 diabetes and can be detected before an elevation of FPG or 2-hPG is observed.https://doi.org/10.1186/s13098-025-01629-4Type 2 diabetesPlasminogen activator inhibitor-1Population studyVästerbotten intervention programme
spellingShingle Jenny Hernestål-Boman
Tina Öhman
Jan-Håkan Jansson
Marcus M. Lind
Olov Rolandsson
Ingvar A. Bergdahl
Lars Johansson
Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus
Diabetology & Metabolic Syndrome
Type 2 diabetes
Plasminogen activator inhibitor-1
Population study
Västerbotten intervention programme
title Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus
title_full Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus
title_fullStr Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus
title_full_unstemmed Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus
title_short Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus
title_sort elevated levels of pai 1 precede the occurrence of type 2 diabetes mellitus
topic Type 2 diabetes
Plasminogen activator inhibitor-1
Population study
Västerbotten intervention programme
url https://doi.org/10.1186/s13098-025-01629-4
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