Role of plasminogen activator inhibitor type 1 (PAI-1) in PCOS patient

Background: There has been few studies done demonstrating elevated level of PAI-1 in women with Polycystic Ovarian Syndrome (PCOS). PAI-1 has been associated with insulin resistance, obesity, anovulatory infertility, increased risk of cardiovascular disease in PCOS patient. The objective of the study was to find out the plasma level of PAI-1 in PCOS and compare with healthy age matched control. To correlate PAI-1 with various demographic, anthropometric, biochemical and hormonal parameters in PCOS patient and specific relation of PAI-1 with the insulin resistance, obesity, hyperandrogenemia.Methods: A prospective case control study was carried out in 50 patients having PCOS (fulfilling Rotterdam Criteria, 2003). 25 healthy age matched control were taken. Blood samples were taken for estimation of fasting glucose, fasting insulin, lipid profile, LH, FSH, Prolactin, Testosterone, insulin sensitive indices (HOMA-IR, glucose: insulin ratio). Plasma level of PAI-1 was estimated with Human ELISA invitorgen kit. The data were statistically analysed with SPSS 16.0 version (student T test, Pearson ranked correlation coefficient, linear regression analysis was applied) and PAI-1 was correlated with various parameters.Results: Mean level of PAI-1 was significantly raised in PCOS patient (893.36±234.97) pg/mL than in control (259.68±97.75) pg/mL (p<0.001). PAI-1 significantly correlated with insulin resistance, obesity; that is; PAI-1 significantly correlated with BMI (r=0.557; p<0.001), waist: hip ratio (r=0.550; p<0.001), fasting glucose (r=0.429; p=0.002), fasting insulin (r=0.357; p=0.001), triglyceride (r=0.492; p=0.000), LDL (r=0.604; p=0.001), HOMA-IR (r=0.467; p=0.001). On regression analysis LDL, fasting insulin, HOMA-IR altogether explained 54.9% of total variability of PAI-1.Conclusions: Plasma level of PAI-1 is elevated in PCOS patient and it is significantly correlated with insulin resistance and obesity