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BioMed Research International
Volume 2017, Article ID 6519704, 9 pages
https://doi.org/10.1155/2017/6519704
Research Article

Hypofibrinolytic State in Subjects with Type 2 Diabetes Mellitus Aggravated by the Metabolic Syndrome before Clinical Manifestations of Atherothrombotic Disease

1Servicio de Medicina Interna, UMAE Hospital de Especialidades, CMN Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
2Servicio de Urgencias, H.G.R. No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro”, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
3Servicio de Neurología, UMAE Hospital de Especialidades, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
4Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
5Unidad de Investigación en Nutrición Médica, CMN Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
6Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, H.G.R. No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro”, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
7Unidad de Investigación Médica en Medicina Reproductiva, UMAE H.G.O. No. 4, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico

Correspondence should be addressed to Irma Isordia-Salas; moc.liamg@6102.osiamri

Received 13 October 2016; Accepted 13 December 2016; Published 8 February 2017

Academic Editor: Stefano de Franciscis

Copyright © 2017 Elsa Aburto-Mejía et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Metabolic and genetic factors induce plasminogen activator inhibitor type-1 (PAI-1) overexpression; higher PAI-1 levels decrease fibrinolysis and promote atherothrombosis. Aim. To assess PAI-1 antigen levels among subjects with type 2 diabetes mellitus (T2DM) plus Metabolic Syndrome (MetS) before clinical manifestations of atherothrombosis and the contribution of metabolic factors and 4G/5G polymorphism of PAI-1 gene on the variability of PAI-1. Methods. We conducted an observational, cross-sectional assay in a hospital in Mexico City from May 2010 to September 2011. MetS was defined by the International Diabetes Federation criteria. PAI-1 levels and 4G/5G polymorphism were determined by ELISA and PCR-RFLP analysis. Results. We enrolled 215 subjects with T2DM plus MetS and 307 controls. Subjects with T2DM plus MetS had higher PAI-1 levels than the reference group (58.4 ± 21 versus 49.9 ± 16 ng/mL, ). A model with components of MetS explained only 12% of variability on PAI-1 levels ( = 0.12; ), with () for hypertension, () for NL HDL-c, and () for NL triglycerides. Conclusion. Subjects with T2DM plus MetS have elevated PAI-1 levels before clinical manifestations of atherothrombotic disease. Metabolic factors have a more important contribution than 4G/5G polymorphism on PAI-1 plasma variability.