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

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.