Objective: Plasminogen activator inhibitor type I (PAI-1) an inhibitor of fibrinolysis and an important and independent cardiovascular risk factor, has been shown to be elevated in obesity. The aim of this study was to evaluate plasma PAI-1 levels in obese subjects and to correlate PAI-1 with metabolic parameters.

Material and Method: We evaluated 44 obese (27 women, 17 men; BMI 37± 5kg/m2) and 24 non-obese subjects (15 women, 9 men; BMI: 23±2.6kg/m2). Fasting glucose, insulin, PAI-1 levels and lipid patterns were determined. Body fat composition was assessed by BMI and WHR (waist to hip circumference ratio). Insulin sensitivity was assessed by using the homeostasis model assessment ratio (HOMA) formula derived from fasting insulin and glucose levels.

Results: The obese subjects had significantly elevated values of PAI-1(p<0,03), total cholesterol (p<0.00), LDL- cholesterol (p<0.00) and fibrinogen (p<0.01) levels with respect to the control group. In the obese subjects glucose levels correlated with PAI-1 levels (p<0.005, r=0.421). The insulin resistant obese subjects had significantly higher PAI-1(p<0.01), glucose (p<0.01), insulin (p<0.01) and BMI (p<0.02) levels than the insulin sensitive group. Subjects with abdominal obesity (WHR; men>0.9, women>0.85) had significantly higher levels of PAI-1, glucose and insulin levels than the peripheral obese subjects and the control group.

Conclusion: Plasma PAI-1 concentrations directly correlated with WHR and insulin resistance and this correlation may contribute to the high risk of cardiovascular events observed in abdominal obesity.