Degree of obesity influences the relationship of PAI-1 with body fat distribution and metabolic variables in African women

- The association of PAI-1 with body fat distribution in Africans is unclear.
- PAI-1 did not differ between SO and non-sarcopenic obese women.
- Fat distribution and degree of obesity influenced the association of PAI-1 with metabolic co-variates.
- Abdominal SCAT is an important contributor to plasma PAI-1 in centrally obese women.
- Body fat % did not contribute significantly to PAI-1 variance in obese African women.

IntroductionAlthough the relationship of plasminogen activator inhibitor-1 (PAI-1) with obesity has been well established, the relationship of PAI-1 with different body fat distribution patterns is less clear particularly in non-white ethnicities.MethodsWe investigated the cross-sectional association of PAI-1act with body fat % and two different body fat distribution patterns, namely sarcopenic obesity (SO) and visceral (VAT) compared to subcutaneous (SCAT) abdominal obesity, in 246 healthy African women by creating sub-groups according to different body fat distribution patterns.ResultsThe PAI-1act level of the SO group did not differ significantly from that of the excessive % body fat, non-sarcopenic group (p = 0.8). The relationship of PAI-1act, with body fat %, insulin, triglycerides and appendicular skeletal mass (ASM) was influenced by body fat distribution patterns and degree of obesity. PAI-1act was higher (1.65 vs 0.16 U/ml; p = 0.001) in women with a proportionally higher abdominal VAT compared to higher abdominal SCAT compartment in the total study population, but not in the centrally obese sub-group (1.72 vs 0.83 U/ml; p = 0.5). Multiple regression models indicated that body fat % per se did not contribute significantly to PAI-1act variance in women with increased fat mass.ConclusionFat distribution patterns and degree of obesity influenced the association of PAI-1act with insulin, triglycerides, ASM and body fat % in African women. In centrally obese women, abdominal VAT no longer contributed more to plasma PAI-1act, than abdominal SCAT. Inflammation and endothelial dysfunction contributed more to PAI-1act variance in obese African women than did body fat % per se.