Plasminogen activator inhibitor-1, inflammation, obesity, insulin resistance and vascular risk


Irène Juhan-Vague, Laboratory Hematology, CHU Timone, 13385 Marseille cedex 5, France.
Tel.: +33 491492449; fax: +33 491942332; e-mail:


Summary.  Elevated plasma plasminogen activator inhibitor-1 (PAI-1) level is a core feature of insulin-resistance syndrome (IRS). Atherothrombotic complications in IRS are partly attributed to impaired fibrinolysis caused by increased plasma PAI-1 levels. Although the etiology of IRS is far from being explained, the clustering of inflammation, adipose tissue accumulation and insulin resistance suggests an etiopathological link. Proinflammatory cytokines might regulate PAI-1 expression in IRS; however, more studies are needed to confirm this complex mechanism in humans. Furthermore, modifying PAI-1 expression by PAI-1 inhibitors provides a new challenge and may reveal the true role of PAI-1 in atherosclerotic and insulin resistance processes.