Plasminogen activator inhitor-1 associates with cardiovascular risk factors in healthy young adults in the Cardiovascular Risk in Young Finns Study

• Published in: Atherosclerosis Vol. 224; no. 1; pp. 208 - 212
• Main Authors: Raiko, Juho R.H, Oikonen, Mervi, Wendelin-Saarenhovi, Maria, Siitonen, Niina, Kähönen, Mika, Lehtimäki, Terho, Viikari, Jorma, Jula, Antti, Loo, Britt-Marie, Huupponen, Risto, Saarikoski, Liisa, Juonala, Markus, Raitakari, Olli T
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.09.2012; Elsevier
• Subjects: Adult; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; Cardiovascular risk; Carotid Intima-Media Thickness; Cholesterol, HDL - blood; Cohort study; Coronary heart disease; Epidemiology; Female; Fibrinolysis; Heart; Humans; Male; Medical sciences; Plasminogen Activator Inhibitor 1 - blood; Plasminogen activator inhibitor-1; Risk Factors; Ultrasound; Cohort study; Carotid intima-media thickness; Cardiovascular risk; Atherosclerosis; Plasminogen activator inhibitor-1; Fibrinolysis; Ultrasound; Epidemiology; Human; Cardiovascular disease; Artery; Vascular disease; Plasminogen activator inhibitor 1; Blood vessel; Carotid; Young adult; Risk factor; Circulatory system; Plasminogen
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2012.06.062

Abstract Aims Hypofibrinolysis displayed by elevated serum plasminogen activator inhibitor 1 (PAI-1) level has been associated with cardiovascular disease (CVD) and its risk factors such as obesity and insulin resistance. However, no studies have examined associations between PAI-1 and CVD risk factors in healthy subjects. We examined associations between serum PAI-1, ultrasound markers of atherosclerosis and CVD risk factors and whether PAI-1 improves prediction of atherosclerosis over known risk factors in a cohort of asymptomatic adults. Methods We analyzed PAI-1 and CVD risk factors and assessed carotid intima-media thickness (cIMT), distensibility (CDist) and the presence of a carotid atherosclerotic plaque and flow-mediated dilation (FMD) ultrasonographically for 2202 adults (993 men and 1,209 women, aged 30–45 years) participating in the ongoing longitudinal cohort study, The Cardiovascular Risk in Young Finns Study. High cIMT was defined as >90th percentile and/or carotid plaque and low CDist and low FMD as <20th percentile. Results In bivariate analyses, PAI-1 correlated directly with cIMT and the risk factors: blood pressure, BMI, waist and hip circumference, alcohol use, total and LDL-cholesterol, triglycerides, glomerular filtration rate, high-sensitivity CRP and glucose (all P < 0.005). PAI-1 was higher in men and increased with age. Inverse correlation was observed with CDist, HDL-cholesterol and adiponectin in both sexes, with testosterone and sex hormone binding globulin in men and with creatinine and oral contraceptive use in women ( P < 0.005). Independent direct associations were observed between PAI-1 and waist circumference, serum triglycerides, insulin, alcohol use and age and inverse with serum creatinine, HDL-cholesterol and adiponectin. PAI-1 did not improve estimation of high cIMT, low CDist and low FMD over conventional risk factors ( P for difference in area under curve ≥ 0.37). Conclusion PAI-1 was independently associated with several known CVD risk factors, especially obesity markers, in both men and women. However, addition of PAI-1 to known risk factors did not improve cross-sectional prediction of high cIMT, low CDist and low FMD suggesting that PAI-1 is not a clinically important biomarker in early atherosclerosis.