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PAI-1, Obesity, and Insulin Resistance

  • Chapter
Insulin Resistance

Part of the book series: Contemporary Endocrinology ((COE,volume 12))

Abstract

Thrombosis favors the development of vascular damage and is responsible for many complications of atherosclerosis. It occurs primarily at the site of a ruptured atherosclerotic plaque and can be incorporated into the vascular wall. This event is partly determined by the thrombotic/thrombolytic equilibrium at the time of plaque rupture. Thrombolytic potential is mainly under the control of an inhibitor of plasminogen activation (PAI-1), whose modulation has been shown to influence fibrin and extracellular matrix accumulation. Elevated PAI-1 concentration in plasma is presently considered a risk factor for coronary vascular events (1,2). Moreover, an elevation of circulating PAI-1 has been shown to be associated with insulin-resistance with obesity and noninsulin dependent diabetes (3). It has thus been postulated (3) that PAI-1 could contribute to increased susceptibility to atherothrombosis in insulin-resistant patients (4–9). The elucidation of the regulation of PAI-1 synthesis and the identification of factors responsible for increased plasma PAI-1 concentration in the insulin resistance states might lead to therapeutic concepts for prevention of vascular lesions.

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Authors
  1. Irène Juhan-Vague MD, PhD
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  2. Marie-Christine Alessi MD, PhD
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  3. Pierre E. Morange MD, PhD
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Editors and Affiliations

  1. Shaman Pharmaceuticals, Inc., South San Francisco, CA, USA

    Gerald M. Reaven MD

  2. Stanford University School of Medicine, Stanford, CA, USA

    Gerald M. Reaven MD

  3. Stanford University School of Medicine, Stanford, CA, USA

    Ami Laws MD

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Juhan-Vague, I., Alessi, MC., Morange, P.E. (1999). PAI-1, Obesity, and Insulin Resistance. In: Reaven, G.M., Laws, A. (eds) Insulin Resistance. Contemporary Endocrinology, vol 12. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-716-1_17

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  • DOI: https://doi.org/10.1007/978-1-59259-716-1_17

  • Publisher Name: Humana Press, Totowa, NJ

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