Plasminogen activator inhibitor‐1 and HbA1c defined prediabetes: the Guangzhou Biobank Cohort Study‐CVD

Summary Objective  To examine the association between plasminogen activator inhibitor-1 (PAI-1) and diabetes status. Research Design and Methods  One thousand three hundred and ninety-three older Chinese were randomly selected from the Guangzhou Biobank Cohort Study. Diabetes status was classified as impaired HbA1c (IA1c) level of 5·7–6·4%, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or diabetes using the American Diabetes Association diagnosis criteria in 2010. Results  Compared to the normoglycemic (NG) group, 421 subjects with IA1c, but without diabetes, IFG or IGT, had adverse levels of vascular risk factors, including PAI-1, lipid profile, blood pressure and anthropometry. After adjusting for multiple potential confounders, compared to the NG group, the level of plasma PAI-1 was independently and significantly increased in the IA1c and the IFG/IGT group (mean difference: 32·0 (95% confidence interval: 5·5–58·6) ng/ml and 33·3 (6·3–60·3) ng/ml, respectively; P < 0·01). Conclusions  Plasma PAI-1 level was increased in people with haemoglobin A1c (HbA1c) of 5·7–6·4% but without IFG or IGT, and in people with IFG/IGT, suggesting an increased risk for future diabetes and cardiovascular diseases in these groups.