The association of three components of fibrinolysis with fasting insulin and triglycerides: The ARIC study

V. Salomaa, D. Liao, J. D. Kark, K. K. Wu, A. R. Folsom, C. E. Davis

Research output: Contribution to journalArticle

Abstract

Background and Aim: The regulation of fibrinolytic activity takes place mainly through the fast-acting inhibitor of the plasminogen activator (PAI-1), but the regulatory mechanisms are not yet established. The aim of the present study was to characterize in a healthy, free-living population the associations of insulin, glucose and triglycerides (Tg) with three parameters of fibrinolysis, D-dimer, tissue plasminogen activator antigen (t-PA:Ag), and PAI-1:Ag. Methods and Results: We performed a cross-sectional analysis of pooled data from a community based case-control study. The study sample included 841 black and white men and women, aged 45 to 64 years, who participated in the Atherosclerosis Risk in Communities (ARIC) Study. Both t-PA:Ag and PAI-1:Ag were significantly and positively correlated with insulin, glucose and Tg, whereas the D-dimer was not. The regression coefficients of insulin, glucose and Tg were in all race-sex groups almost twice as strong for PAI-1:Ag as for t-PA:Ag. In white men, for example, approximately one standard deviation (SD) difference (75%) in plasma insulin was associated with a predicted difference of 15.4% (95% confidence interval 11.7-19.1%) in t-PA:Ag and 32.6% (23.1-42.9%) in PAI-1:Ag. Similar results were obtained for Tg. Thus, the percentage difference in PAI-1:Ag associated with one SD difference in insulin or Tg was significantly greater than the corresponding difference in t-PA:Ag. Furthermore, the relation between t-PA:Ag and PAI-1:Ag depends on the insulin level, especially in white women, thus a given t-PA:Ag value predicted a higher value of PAI-1:Ag in persons with high insulin than in persons with low insulin. Conclusions: In the healthy, free-living population in this study insulin and Tg were significantly associated with t-PA:Ag and PAI-1:Ag, but not with the D-dimer. These associations were approximately similar in white and blacks. Insulin modified the relation between t-PA:Ag and PAI-1:Ag in a way which is consistent with impaired fibrinolysis in persons with high insulin.

Original languageEnglish (US)
Pages (from-to)277-286
Number of pages10
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume8
Issue number5
StatePublished - Oct 1 1998

Fingerprint

Fibrinolysis
Plasminogen Activator Inhibitor 1
Fasting
Atherosclerosis
Triglycerides
Insulin
Tissue Plasminogen Activator
Antigens
Glucose
Plasminogen Inactivators
Population
Case-Control Studies
Cross-Sectional Studies
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

Cite this

Salomaa, V. ; Liao, D. ; Kark, J. D. ; Wu, K. K. ; Folsom, A. R. ; Davis, C. E. / The association of three components of fibrinolysis with fasting insulin and triglycerides : The ARIC study. In: Nutrition, Metabolism and Cardiovascular Diseases. 1998 ; Vol. 8, No. 5. pp. 277-286.
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abstract = "Background and Aim: The regulation of fibrinolytic activity takes place mainly through the fast-acting inhibitor of the plasminogen activator (PAI-1), but the regulatory mechanisms are not yet established. The aim of the present study was to characterize in a healthy, free-living population the associations of insulin, glucose and triglycerides (Tg) with three parameters of fibrinolysis, D-dimer, tissue plasminogen activator antigen (t-PA:Ag), and PAI-1:Ag. Methods and Results: We performed a cross-sectional analysis of pooled data from a community based case-control study. The study sample included 841 black and white men and women, aged 45 to 64 years, who participated in the Atherosclerosis Risk in Communities (ARIC) Study. Both t-PA:Ag and PAI-1:Ag were significantly and positively correlated with insulin, glucose and Tg, whereas the D-dimer was not. The regression coefficients of insulin, glucose and Tg were in all race-sex groups almost twice as strong for PAI-1:Ag as for t-PA:Ag. In white men, for example, approximately one standard deviation (SD) difference (75{\%}) in plasma insulin was associated with a predicted difference of 15.4{\%} (95{\%} confidence interval 11.7-19.1{\%}) in t-PA:Ag and 32.6{\%} (23.1-42.9{\%}) in PAI-1:Ag. Similar results were obtained for Tg. Thus, the percentage difference in PAI-1:Ag associated with one SD difference in insulin or Tg was significantly greater than the corresponding difference in t-PA:Ag. Furthermore, the relation between t-PA:Ag and PAI-1:Ag depends on the insulin level, especially in white women, thus a given t-PA:Ag value predicted a higher value of PAI-1:Ag in persons with high insulin than in persons with low insulin. Conclusions: In the healthy, free-living population in this study insulin and Tg were significantly associated with t-PA:Ag and PAI-1:Ag, but not with the D-dimer. These associations were approximately similar in white and blacks. Insulin modified the relation between t-PA:Ag and PAI-1:Ag in a way which is consistent with impaired fibrinolysis in persons with high insulin.",
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The association of three components of fibrinolysis with fasting insulin and triglycerides : The ARIC study. / Salomaa, V.; Liao, D.; Kark, J. D.; Wu, K. K.; Folsom, A. R.; Davis, C. E.

In: Nutrition, Metabolism and Cardiovascular Diseases, Vol. 8, No. 5, 01.10.1998, p. 277-286.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The association of three components of fibrinolysis with fasting insulin and triglycerides

T2 - The ARIC study

AU - Salomaa, V.

AU - Liao, D.

AU - Kark, J. D.

AU - Wu, K. K.

AU - Folsom, A. R.

AU - Davis, C. E.

PY - 1998/10/1

Y1 - 1998/10/1

N2 - Background and Aim: The regulation of fibrinolytic activity takes place mainly through the fast-acting inhibitor of the plasminogen activator (PAI-1), but the regulatory mechanisms are not yet established. The aim of the present study was to characterize in a healthy, free-living population the associations of insulin, glucose and triglycerides (Tg) with three parameters of fibrinolysis, D-dimer, tissue plasminogen activator antigen (t-PA:Ag), and PAI-1:Ag. Methods and Results: We performed a cross-sectional analysis of pooled data from a community based case-control study. The study sample included 841 black and white men and women, aged 45 to 64 years, who participated in the Atherosclerosis Risk in Communities (ARIC) Study. Both t-PA:Ag and PAI-1:Ag were significantly and positively correlated with insulin, glucose and Tg, whereas the D-dimer was not. The regression coefficients of insulin, glucose and Tg were in all race-sex groups almost twice as strong for PAI-1:Ag as for t-PA:Ag. In white men, for example, approximately one standard deviation (SD) difference (75%) in plasma insulin was associated with a predicted difference of 15.4% (95% confidence interval 11.7-19.1%) in t-PA:Ag and 32.6% (23.1-42.9%) in PAI-1:Ag. Similar results were obtained for Tg. Thus, the percentage difference in PAI-1:Ag associated with one SD difference in insulin or Tg was significantly greater than the corresponding difference in t-PA:Ag. Furthermore, the relation between t-PA:Ag and PAI-1:Ag depends on the insulin level, especially in white women, thus a given t-PA:Ag value predicted a higher value of PAI-1:Ag in persons with high insulin than in persons with low insulin. Conclusions: In the healthy, free-living population in this study insulin and Tg were significantly associated with t-PA:Ag and PAI-1:Ag, but not with the D-dimer. These associations were approximately similar in white and blacks. Insulin modified the relation between t-PA:Ag and PAI-1:Ag in a way which is consistent with impaired fibrinolysis in persons with high insulin.

AB - Background and Aim: The regulation of fibrinolytic activity takes place mainly through the fast-acting inhibitor of the plasminogen activator (PAI-1), but the regulatory mechanisms are not yet established. The aim of the present study was to characterize in a healthy, free-living population the associations of insulin, glucose and triglycerides (Tg) with three parameters of fibrinolysis, D-dimer, tissue plasminogen activator antigen (t-PA:Ag), and PAI-1:Ag. Methods and Results: We performed a cross-sectional analysis of pooled data from a community based case-control study. The study sample included 841 black and white men and women, aged 45 to 64 years, who participated in the Atherosclerosis Risk in Communities (ARIC) Study. Both t-PA:Ag and PAI-1:Ag were significantly and positively correlated with insulin, glucose and Tg, whereas the D-dimer was not. The regression coefficients of insulin, glucose and Tg were in all race-sex groups almost twice as strong for PAI-1:Ag as for t-PA:Ag. In white men, for example, approximately one standard deviation (SD) difference (75%) in plasma insulin was associated with a predicted difference of 15.4% (95% confidence interval 11.7-19.1%) in t-PA:Ag and 32.6% (23.1-42.9%) in PAI-1:Ag. Similar results were obtained for Tg. Thus, the percentage difference in PAI-1:Ag associated with one SD difference in insulin or Tg was significantly greater than the corresponding difference in t-PA:Ag. Furthermore, the relation between t-PA:Ag and PAI-1:Ag depends on the insulin level, especially in white women, thus a given t-PA:Ag value predicted a higher value of PAI-1:Ag in persons with high insulin than in persons with low insulin. Conclusions: In the healthy, free-living population in this study insulin and Tg were significantly associated with t-PA:Ag and PAI-1:Ag, but not with the D-dimer. These associations were approximately similar in white and blacks. Insulin modified the relation between t-PA:Ag and PAI-1:Ag in a way which is consistent with impaired fibrinolysis in persons with high insulin.

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