t-PA

Plasminogen activator inhibitor-1 (PAI-1) levels are elevated in metabolic disorders such as obesity, hypertension, and diabetes, suggesting a link between hypofibrinolysis and atherosclerotic complications in insulin-resistant states. This study investigated the effects of insulin on fibrinolysis by assessing PAI-1 and tissue plasminogen activator (tPA) antigen levels during insulin infusion in the forearm vascular beds of healthy individuals. Insulin infusion significantly increased forearm blood flow and altered fibrinolytic balance, with a transient rise in PAI-1 levels at 60 minutes and a subsequent increase in tPA at 90 minutes. These findings indicate that local hyperinsulinemia modulates vascular tone and fibrinolytic protein expression, suggesting that dysregulation of this response may contribute to impaired fibrinolysis and the progression of atherosclerosis in insulin-resistant conditions.