Association of the metabolic syndrome with PAI 1act and clot lysis time over a 10-year follow up in an African population

Albe C Swanepoel; Mari van Reenen; Zelda de Lange-Loots; Marlien Pieters

doi:10.1016/j.numecd.2022.12.011

Association of the metabolic syndrome with PAI 1_act and clot lysis time over a 10-year follow up in an African population

Nutr Metab Cardiovasc Dis. 2023 Mar;33(3):592-601. doi: 10.1016/j.numecd.2022.12.011. Epub 2022 Dec 17.

Authors

Albe C Swanepoel¹, Mari van Reenen², Zelda de Lange-Loots³, Marlien Pieters⁴

Affiliations

¹ Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa.
² Human Metabolomics, North-West University, Potchefstroom, South Africa.
³ Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Medical Research Council Extramural Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
⁴ Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Medical Research Council Extramural Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa. Electronic address: marlien.pieters@nwu.ac.za.

PMID: 36646603
DOI: 10.1016/j.numecd.2022.12.011

Abstract

Background and aims: The association between the metabolic syndrome (MetS) and plasminogen activator inhibitor-1 (PAI-1) has been well established in cross-sectional studies. It is less clear whether this translates into decreased clot lysis rates and very little information is available on non-European populations. Little is known regarding prospective associations and whether clot lysis progressively worsens in MetS individuals over time. We determined the prospective association of MetS with PAI-1 activity (PAI-1_act) and clot lysis time (CLT) over a 10-year period.

Methods and results: As many as 2010 African men and women aged ≥30 years were stratified according to MetS status and number of MetS criteria (0-5). We also determined the contribution of the PAI-1 4G/5G polymorphism to these associations and identified which MetS criteria had the strongest associations with PAI-1_act and CLT. Both PAI-1_act and CLT remained consistently elevated in individuals with MetS throughout the 10-year period. PAI-1_act and CLT did not increase more over time in MetS individuals than in controls. The 4G/5G genotype did not influence the association of PAI-1_act or clot lysis with MetS. Increased waist circumference, increased triglycerides and decreased HDL-C were the main predictors of PAI-1_act and CLT.

Conclusions: Black South Africans with MetS had increased PAI-1_act and longer CLTs than individuals without MetS. The inhibited clot lysis in MetS did, however, not deteriorate over time compared to controls. Of the MetS criteria, obesity and altered lipids were the main predictors of PAI-1_act and CLT and are thus potential targets for prevention strategies to decrease thrombotic risk.

Keywords: 4G/5G polymorphism; African; Fibrin clot lysis time; Metabolic syndrome; Plasminogen activator inhibitor 1.

Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Female
Fibrin Clot Lysis Time
Follow-Up Studies
Humans
Male
Metabolic Syndrome* / diagnosis
Metabolic Syndrome* / epidemiology
Metabolic Syndrome* / genetics
Plasminogen Activator Inhibitor 1 / genetics

Substances

Plasminogen Activator Inhibitor 1
SERPINE1 protein, human