Plasminogen activator inhibitor‐1, inflammation, obesity, insulin resistance and vascular risk

Elevated plasma plasminogen activator inhibitor‐1 (PAI‐1) level is a core feature of insulin‐resistance syndrome (IRS). Atherothrombotic complications in IRS are partly attributed to impaired fibrinolysis caused by increased plasma PAI‐1 levels. Although the etiology of IRS is far from being explained, the clustering of inflammation, adipose tissue accumulation and insulin resistance suggests an etiopathological link. Proinflammatory cytokines might regulate PAI‐1 expression in IRS; however, more studies are needed to confirm this complex mechanism in humans. Furthermore, modifying PAI‐1 expression by PAI‐1 inhibitors provides a new challenge and may reveal the true role of PAI‐1 in atherosclerotic and insulin resistance processes.