Association Between Plasma Levels Of PAI-1,tPA/PAI-1 Molar Ratio,and Mild Cognitive Impairment In Chinese Patients With Type 2 Diabetes Mellitus

Background and Objective:Plasminogen activator inhibitor 1(PAI-1)and tissue plasminogen activator(tPA)are involved in the complications of type 2 diabetes mellitus(T2DM)and early pathology of Alzheimer’s disease.This study aimed to investigate the association between plasma PAI-1,tPA/PAI-1 molar ratio,and mild cognitive impairment(MCI)in Chinese T2 DM patients.Methods:A total of 162 Chinese T2 DM patients were recruited and divided into two groups according to the Montreal Cognitive Assessment score.Demographic data were collected,plasma PAI-1 and tPA levels were measured through enzyme-linked immunosorbent assay,tPA/PAI-1 molar ratio was calculated,and neuropsychological test results were examined.The association between PAI-1,tPA/PAI-1 molar ratio,and cognition was analyzed.Results:1.T2 DM patients with MCI displayed significantly increased plasma PAI-1 levels(p = 0.016)and decreased tPA/PAI-1 molar ratio(P = 0.021)compared with the controls.2.High PAI-1 levels and low tPA/PAI-1 molar ratio were associated with MCI in T2 DM patients,e.g.,plasma level of PAI-1 were negatively correlated(r =-0.343,P= 0.007)with logic memory in T2 DM patients with MCI.3.Linear regression analysis further revealed that PAI-1 concentration was an independent factor of diabetic MCI(P = 0.001).Conclusions:1.High PAI-1 levels and low tPA/PAI-1 molar ratio were significantly correlated with T2DM-associated cognitive impairment,especially memory function,in Chinese patients.2.Plasma PAI-1 level and tPA/ PAI-1 may be biomarkers for the early diagnosis of T2 DM with MCI.3.The roles of plasma PAI-1 and tPA in type 2 diabetes mellitus with cognitive impairment need to be confirmed by further studies.