PAI-1 Plasma Levels in a General Population Without Clinical Evidence of Atherosclerosis

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Abstract
—Plasminogen activator inhibitor-1 (PAI-1) plasma levels have been consistently related to a polymorphism (4G/5G) of the PAI-1 gene. The renin-angiotensin pathway plays a role in the regulation of PAI-1 plasma levels. An insertion ( I )/deletion ( D ) polymorphism of the angiotensin-converting enzyme (ACE) gene has been related to plasma and cellular ACE levels. In 1032 employees (446 men and 586 women; 22 to 66 years old) of a hospital in southern Italy, we investigated the association between PAI-1 4G/5G and the ACE I/D gene variants and plasma PAI-1 antigen levels. None of the individuals enrolled had clinical evidence of atherosclerosis. In univariate analysis, PAI-1 levels were significantly higher in men ( P <.001), alcohol drinkers ( P <.001), smokers ( P =.009), and homozygotes for the PAI-1 gene deletion allele (4G/4G) ( P =.012). Multivariate analysis documented the independent effect on PAI-1 plasma levels of body mass index ( P <.001), triglycerides ( P <.001), sex ( P <.001), PAI-1 4G/5G polymorphism ( P =.019), smoking habit ( P =.041), and ACE I/D genotype ( P =.042). Thus, in addition to the markers of insulin resistance and smoking habit, gene variants of PAI-1 and ACE account for a significant portion of the between-individual variability of circulating PAI-1 antigen concentrations in a general population without clinical evidence of atherosclerosis.