Plasma t-PA and PAI-1 Antigen Concentrations in Non-Insulin Dependent Diabetic Patients: Effects of Treatment Modality on Fibrinolysis

Basal plasma tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) antigen levels were studied in 49 non-insulin dependent diabetic patients (23 men, 26 women: ages 51.3±14.9 years) and 16 age matched non-diabetic subjects (9 men, 7 women: ages 49.8±12.2 years) as a control group. Compared to a control group, the diabetic patients had a significantly higher mean t-PA antigen (5.15±3.02 vs 3.20±2.30 ng/ml) and PAI-1 antigen (35.89±18.59 vs 17.60±15.36 ng/ml) levels (p<0.05). Plasma t-PA antigen level was not influenced by each treatment modality. There was a significant decrease of plasma PAI-1 antigen level after Metformin administration compared to that of before Metformin administration (39.74±19.39 vs 25.14±16.18 ng/ml) (p<0.05), and the insulin-treated group showed a tendency for a decrease of plasma PAI-1 antigen levels after insulin administration but this did not reach statistical significance (29.93±15.37 vs 17.32±10.60 ng/ml). Sulfonylurea did not change both plasma t-PA and PAI-1 antigen levels. In conclusion, diabetic patients have high t-PA and PAI-1 antigen levels. Biguanide reduced plasma PAI-1 antigen levels, which might play some helpful role in the improvement of chronic complications in NIDDM.