t-PA

This prospective study examined the relationship between endothelial dysfunction markers—tissue plasminogen activator (t-PA) antigen and von Willebrand factor (vWF) antigen—and the development of type 2 diabetes in a cohort of 3,562 nondiabetic men over seven years. Elevated t-PA levels were associated with a nearly threefold increase in diabetes risk, even after adjusting for lifestyle factors and adiposity, whereas vWF showed only a marginal association. Both markers correlated with inflammation (IL-6, CRP), hepatic function (GGT), and insulin resistance, with t-PA demonstrating stronger associations. Notably, t-PA was inversely correlated with adiponectin, and while adjustments for inflammation, adipokines, and hepatic function attenuated the vWF-diabetes link, t-PA remained significantly associated with increased diabetes risk even after controlling for insulin resistance. These findings suggest that elevated t-PA antigen is an independent predictor of type 2 diabetes, highlighting the role of endothelial dysfunction in metabolic disease progression