Relationship between fibrinolytic and metabolic variables: A study in patients attending a lipid clinic

Luciana Mussoni, Damiano Baldassarre, Luisa Mannucci, Cesare R. Sirtori, Elena Tremoli

Research output: Contribution to journalArticlepeer-review


We investigated the relationship between plasma levels of metabolic and fibrinolytic variables in 163 fasted patients attending a lipid clinic. Of these patients, 118 had hypertriglyceridaemia (HTG) and 45 had normotriglyceridaemia (NTG). In HTG, basal fibrinolytic activity, ie tissue plasminogen activator (t-PA) activity, was impaired as a result of high plasminogen activator inhibitor type 1 (PAI-1) antigen and activity. Multiple stepwise regression analysis identified insulin and triglyceride levels as independent determinants of plasma PAI-1 levels (R2 = 0.18; P = 0.0001). When the patients were stratified into tertiles according to their levels of triglyceride and insulin, PAI-1 antigen levels were found to increase with rising levels of triglyceride in each insulin tertile. In contrast, the increase of PAI-1 with rising insulin levels was evident in the highest triglyceride tertile. In addition, subjects in the lowest tertile of both triglyceride and insuIin had the lowest PAI-1 antigen levels, and subjects in the highest tertile of both triglyceride and insulin had the highest levels of PAI-1. Both basal and stimulated levels of t-PA antigen were significantly higher in HTG than in NTG. Multiple stepwise regression analysis identified triglyceride level as the sole major determinant of t-PA antigen levels (R2 = 0.13; P = 0.00003). The observation that both insulin and triglycerides correlate with PAI-1, whereas triglycerides were involved only in the increased secretion of t-PA, suggests that these two proteins are regulated by different mechanisms.

Original languageEnglish
Pages (from-to)134-141
Number of pages8
JournalAnnals of Medicine
Issue number2
Publication statusPublished - Mar 2000


  • Hypertriglyceridaemia
  • Insulin
  • Plasminogen activator inhibitor type 1
  • Tissue-type plasminogen activator
  • Triglycerides

ASJC Scopus subject areas

  • Medicine(all)


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