Aim: 

to evaluate alterations in plasminogen activator inhibitor-1 (PAI-1), myeloperoxidase (MPO) and matrix metalloproteinase-9 (MMP-9) levels, endothelial-dependent vasodilatation and their relation to insulin resistance (IR) in metabolic syndrome (MS) patients with and without type-2 diabetes mellitus (T2DM) and coronary artery disease (CAD).

Patients and methods: 

MS patients were recruited into three groups: 22 patients with T2DM (D); 22 patients with T2DM and CAD (A); and 22 patients without T2DM and CAD (M). 22 healthy subjects were selected as controls (C). The study groups were matched for age and sex. IR was measured by HOMA-IR method. Serum PAI-1 (total), MPO and MMP- 9 were measured by xMAP technology (Luminex-200 analyzer). We used laser Doppler imaging (moorLDI2) in conjunction with iontophoretic application of 1% acetylcholine (LDI-ACh) solution for evaluation of cutaneous endothelium- dependent vasodilatation in the hand.

Results: 

All patient groups demonstrated a significant increase in PAI-1, MPO and MMP-9 levels (p<0.05) and IR indexes (p<0.01), but a decrease in LDI- ACh was only found in D and A groups compared to C group (p<0.05). Only the concentration of PAI- 1 and MMP-9 correlated with HOMA-IR indexes (p<0.05).

Conclusion: 

Our findings show that MS patients with and without T2DM and CAD have an increase in PAI-1, MPO and MMP-9 concentrations, increased IR, and decreased endothelial- dependent vasodilatation.