The Relationship Between The Plasma Levels Of Plasminogen Activator Inhibitor-1 And The Type 2 Diabetes Mellitus Macro-vascular Complication In The Patients With Different Age

Objective To investigate the inter-relationship between the plasma levels of plasminogen activator inhibitor-1 and the type 2 diabetes mellitus macro- vascular complication in the patients with different age.Methods The plasma concentrations of Plasminogen activator inhibitor-1(PAI-1) were determined by ELISA in 49 control subjects (Control group) and 246 diabetic patients,which were further subdivided into 6 subgroups(the youth with diabetes mellitus macro-vascular complication, the youth without diabetes mellitus macro-vascular complication, the middle-age with diabetes mellitus macro-vascular complication, the middle-age without diabetes mellitus macro-vascular complication, the aged with diabetes mellitus macro-vascular complication, the aged without diabetes mellitus macro-vascular complication),based on age and with or without macro-vascular complications. Then we observed body mass index, waist-to-hipratio, biochemistry, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, glucose, glycosylated hemoglobin, glycosylated serum protein, free fatty acid, fasting insulin, fasting C-peptide, urine albumin excretion ratio, C- reactive protein, interleukin, tumor necrosis factor and PAI-1 plasma levels in each group. We also observed the factors that have an influence on PAI-1. Study results were analyzed using the SPSS11.5.Results 1,The serum levels of PAI-1 became significantly high in type 2 diabetes mellitus with the increased age, nevertheless their course of disease were not different (p<0.05). PAI-1 in the middle-age without diabetes mellitus macro-vascular complications were obviously higher than that in normal control (p<0.05). PAI-1 inthe middle-age with diabetes mellitus macro-vascular complications were much obviously higher than that in normal control (p<0.01). The PAI-1 levels of macro-vascular patients were higher that in without macro-vascular patients group, in the corresponding age group( the youth and the middle-age group P<0.05, the aged group p<0.01). 3,The diabetic patients were divided into 3 groups according to age. There were significantly positive correlations between PAI-1 and WHR(γ=0.384 P<0.01),TG(γ=0.423 P<0.01),GSP(γ=0.289 P<0.05),FINS(γ=0.481 P<0.01) and UAER(γ=0.451 P<0.01)in the youth group. There were significantly positive correlations between PAI-1 and UA(γ=0.262 P<0.05)in the middle-age group. There were significantly positive correlations between PAI-1 and TCH(γ=0.185 P<0.05)in the aged group. 4,The diabetic patients were divided into 2 groups according to with or without diabetes mellitus macro-vascular complication. Multivariant stepwise regression analysis revealed that there were linear regession relationship between PAI-1 and AGE(β=0.532 P<0.01),IL-6(β=0.200 P<0.01),FFA(β=0.193 P<0.01),CRP(β=0.162 P<0.01),BMI(β=0.121 P<0.01)and FINS(β=0.098 P<0.05)in the diabetes mellitus with macro-vascular complication.Conclusions The plasma level of PAI-1 might be the ligament of the obesity, insulin resistance and athrosclerosis. The plasma level of PAI-1 might be correlated to the type 2 diabetes mellitus macro-vascular complication. PAI-1 may be the independent risk factor in the pathogenesis of type 2 diabetes mellitus macro-vascular complication and promote the development of macro-vascular complication. The plasma levels of PAI-1 increased along with the increase of age at the diabetic patients. With the increase of PAI-1, the activity of fibrinolysis was reduce at the aged and then the risk of development of cardiovascular and celebral vascular diseases would significantly increase. It's important to the youth and the middle-age patients to controll the risk factors of metabolic syndrome in overall, so as to reduce the plasma level of PAI-1 and to prevent the development of macro-vascular complication. But to the aged patients , earlier anticoagulation treatment might be one of a direct method to prevent the development of macro-vascular complication, excepted to controll the risk factors of metabolic syndrome such as hyperlipidemia.