Association among Fibrinolytic Proteins, Metabolic Syndrome Components, Insulin Secretion, and Resistance in Schoolchildren.

Jin-Shuen Chen,Nain-Feng Chu,Chung-Ze Wu,Yuh-Feng Lin,Dee Pei,Li-Chien Chang

doi:10.1155/2015/170987

Abstract

We investigated the role of urokinase plasminogen activator (uPA) and its soluble receptors (suPAR) and plasminogen activator inhibitor-1 (PAI-1) in metabolic syndrome (MetS) components, insulin secretion, and resistance in schoolchildren. We enrolled 387 children, aged 10.3 ± 1.5 years, in Taipei. Anthropometry, fibrinolytic proteins, MetS components, insulin secretion, and resistance were measured. Subjects were divided into normal, overweight, and obese groups. Finally, the relationship between fibrinolytic proteins and metabolic syndrome in boys and girls was analyzed. In boys, PAI-1 was positively associated with body mass index (BMI) percentile, hypertriglyceride, insulin secretion, and resistance. In girls, PAI-1 was positively associated with obesity, hypertriglyceridemia, and insulin secretion. In girls, uPA was positively associated with insulin secretion. suPAR was positively associated with high-sensitivity C-reactive protein in both boys and girls, and with BMI percentile and body fat in girls. The obese boys had higher suPAR and PAI-1 levels than the normal group. The obese girls had higher uPA, suPAR, and PAI-1 than the normal group. Boys and girls with MetS had higher PAI-1. Fibrinolytic proteins, especially PAI-1, are associated with MetS components and insulin secretion in children. Fibrinolytic proteins changes were more likely to occur in girls than in boys.

Highlights

Metabolic syndrome (MetS) started as a concept rather than a diagnosis [1]
We explored the relationship among urokinase plasminogen activator (uPA), soluble uPAR (suPAR), plasminogen activator inhibitor-1 (PAI-1), and components of metabolic syndrome (MetS) in schoolchildren to determine the relationship among insulin secretion and resistance and changes of fibrinolytic proteins
The levels of uPA were not significantly related to age, components of MetS, High-sensitivity C-reactive protein (hsCRP), insulin resistance, or insulin secretion, but suPAR levels were associated with hsCRP

Summary

Introduction

Metabolic syndrome (MetS) started as a concept rather than a diagnosis [1]. Currently, the definition of MetS is a constellation of interconnected risk factors of metabolic origin that often accompany obesity, the principal symptom, and consist of dyslipidemia, elevated blood pressure, impaired glucose tolerance, a hypercoagulable state, and a proinflammatory state.Childhood obesity is increasing and has become an important public health issue in the world. With an increase in prevalence of obesity in childhood, development of type 2. Urokinase plasminogen activator (uPA) and its receptors (uPAR) are well known as fibrinolytic proteins and commonly used for thrombolytic therapy in occlusive artery disease. Besides their functions in the fibrinolytic cascade, uPA and uPAR are expressed by a variety of hemopoietic cells [3] and upregulated during endotoxemia [4]. It is a reasonable presumption that uPA and suPAR contribute to development of lifestyle-related insulin resistance and MetS. There is no study that shows that uPA/suPAR is associated with or contributes to development of insulin resistance and MetS, especially in children. The role of these fibrinolytic proteins in insulin resistance is critical

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Conclusion