Plasminogen activator inhibitor-1 (PAI-1) in children and adolescents With Type 1 Diabetes Mellitus: relation to diabetic micro-vascular complications and carotid intima media thickness

Background: Plasminogen activator inhibitor-1 (PAI-1) is a fast-acting inhibitor of fibrinolysis that has been linked to increase risk of thrombosis. We determined PAI-1 levels in 80 children and adolescents with type I diabetes (T1DM) compared with 40 healthy controls as a potential marker for micro-vascular complications and assessed the relation to carotid intima media thickness (CIMT) as a synergistic risk factor for development of atherosclerosis. Methods: Patients were divided into 2 groups according to micro-vascular complications. Hemoglobin A1c (HbA1c), urinary albumin excretion, fasting serum lipid profile and PAI-1 levels were measured. CIMT of the common carotid artery was assessed using high resolution ultrasonography. Results: PAI-1 levels were significantly elevated in the group with diabetes compared with control group (p < 0.001). PAI-1 levels were also increased in patients with micro-vascular complications compared with those without (p < 0.001). CIMT was significantly higher in patients, particularly those with micro-vascular complications than patients without complications or controls (p < 0.001). Positive correlations were found between PAI-1 levels and random blood glucose, HbA1c, triglycerides, total cholesterol and CIMT (p < 0.05). Conclusions: Increased plasma PAI-1 may be involved in the state of hypofibrinolysis in patients with T1DM leading to the occurrence of micro-vascular complications and increased risk of atherosclerosis. (C) 2014 Elsevier Inc. All rights reserved.