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PAI-1 levels are related to insulin resistance and carotid atherosclerosis in subjects with familial combined hyperlipidemia
  1. Arturo Carratala1,
  2. Sergio Martinez-Hervas2,3,4,
  3. Enrique Rodriguez-Borja1,
  4. Esther Benito3,
  5. José T Real2,3,4,
  6. Guillermo T Saez5,6,
  7. Rafael Carmena2,3,
  8. Juan F Ascaso2,3,4
  1. 1 Service of Clinical Biochemistry and Molecular Biology, University Clinical Hospital of Valencia, Valencia, Spain
  2. 2 Service of Endocrinology and Nutrition, University Clinical Hospital of Valencia, INCLIVA, Valencia, Spain
  3. 3 Department of Medicine, University of Valencia, Valencia, Spain
  4. 4 CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
  5. 5 Department of Biochemistry and Molecular Biology, University of Valencia, INCLIVA, Valencia, Spain
  6. 6 Service of Clinical Analysis, Dr Peset University Hospital, Valencia, Spain
  1. Correspondence to Dr Sergio Martinez-Hervas, Service of Endocrinology and Nutrition, Hospital Clí­nico Universitario, Av. Blasco Ibañez 17, Valencia 46010, Spain; sergio.martinez{at}


Familial combined hyperlipidemia (FCH) is a primary atherogenic dyslipidemia with insulin resistance and increased cardiovascular risk. Plasminogen activator inhibitor type 1 (PAI-1) and myeloperoxidase (MPO) activity are associated with proinflammatory and atherothrombotic risk. Our aim was to study the role played by PAI-1 and MPO activity in the carotid atherosclerosis prevalence in FCH subjects. 36 FCH unrelated subjects (17 women) were matched by age and body weight with 36 healthy normolipidemic subjects (19 female). Blood lipids, glucose, insulin, insulin resistance (homeostasis model assessment (HOMA)), MPO, and PAI-1 were determined in both groups. Carotid intima media thickness (IMT) was measured by the same investigator by standardized protocol. No differences in age, body mass index (BMI) or waist circumference were observed between the two groups. HOMA and PAI-1 values were higher in the FCH group, reaching statistical significance in those subjects with insulin resistance. In addition, PAI-1 values correlated significantly with metabolic syndrome components and carotid IMT. It is known that the elevated cardiovascular risk that characterizes FCH is frequently associated with insulin resistance. We have detected that two known proinflammatory and proatherothrombotic factors (MPO and PAI-1) are significantly elevated in FCH subjects with insulin resistance. These results could partly explain the high cardiovascular risk present in FCH subjects.

  • familial combined hyperlipidemia
  • insulin resistance
  • PAI-1
  • myeloperoxidase.

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  • Contributors AC and EB reviewed the charts and collected the data. ERB and GTS performed the statistical analysis. SMH, JTR, JFA conceived and designed the study. SMH, RC and JFA drafted the manuscript. All the authors contributed to the approval of the final version.

  • Funding This work has been supported by a grant from the Spanish Ministry of Health, Instituto de Salud Carlos III (Madrid, Spain) and Fondo Europeo de Desarrollo Regional (FEDER) to GTS (PI13/01848). EB is supported by a grant from CIBERDEM.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethical Committee of the Hospital Clinico Universitario de Valencia.

  • Provenance and peer review Not commissioned; externally peer reviewed.