t-PA | eGDMD

By admin , 18 September 2025

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Literature evidence

Literature link	GPT Summary	Evidence category	Disease type



18235054	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	Mechanism	Insulin resistance
10527036	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.	Mechanism	Insulin resistance
20876721	This study aimed to explore predictors of gestational diabetes mellitus (GDM) by integrating both simple maternal measures and novel biomarkers to determine how effectively GDM can be predicted in the first trimester. The research involved 124 women who developed GDM and 248 control subjects, with data collected on factors such as age, BMI, parity, race, smoking, prior GDM, family history of diabetes, and blood pressure. Blood samples were analyzed for both routine (lipids, high-sensitivity C-reactive protein, and γ-glutamyltransferase) and novel biomarkers (adiponectin, E-selectin, and tissue plasminogen activator [t-PA]). Stepwise regression identified elevated t-PA and low HDL cholesterol as independent predictors of GDM beyond basic maternal factors. Incorporating these biomarkers improved the area under the receiver-operating characteristic curve (AUC-ROC) from 0.824 to 0.861 and the integrated discrimination improvement (IDI) by 0.052, suggesting that GDM prediction can be enhanced by including specific blood measures like lipids and t-PA alongside simple clinical data.	Risk factor	GDM
30205647	This study aimed to evaluate the potential of first trimester maternal biomarkers for predicting gestational diabetes mellitus (GDM). Conducted as a case-control study at the Obstetrics and Gynecology Unit, Clinica Davila, Santiago, Chile, the research included women with singleton pregnancies who were enrolled before 14 weeks of gestation. Blood samples were collected, and at 24-28 weeks, women were classified into GDM and control groups based on a 75-g oral glucose tolerance test (OGTT). The study measured various biomarkers, including fasting blood glucose, insulin, cholesterol, lipids, uric acid, liver enzymes, adiponectin, tissue plasminogen activator (t-PA), leptin, and placental growth factor (PGF). Results showed that women who developed GDM had higher levels of cholesterol, triglycerides, insulin, t-PA, LDL, and homeostasis model assessment (HOMA), with significant differences compared to the control group. The receiver operating characteristic (ROC) curve for these biomarkers achieved an area under the curve (AUC) of 0.870, with a sensitivity of 81.4% and specificity of 80%. These findings suggest that specific biomarkers measured in the first trimester may help identify women at risk for GDM, although further validation in a larger cohort is required.	Risk factor	GDM