Fibrinolytic Activity and Plasminogen Activator Inhibitor-1 Levels in Obese Patients with Metabolic Syndrome in Kano State, North West Nigeria

This study evaluates fibrinolytic activity and plasminogen activator inhibitor-1 (PAI-1) levels in obese patients with metabolic syndrome compared to non-obese controls at Aminu Kano Teaching Hospital, Kano State, North West Nigeria, addressing the fibrinolytic component of the prothrombotic state in metabolic syndrome in the Northern Nigerian population. A case-control analytical study enrolled 100 obese patients meeting the International Diabetes Federation metabolic syndrome criteria and 50 non-obese, non-metabolic syndrome controls. Plasma PAI-1 antigen, tissue plasminogen activator (t-PA) antigen, euglobulin clot lysis time (ECLT), D-dimer, fibrinogen, and von Willebrand factor were measured. Adiponectin and high-sensitivity CRP were assessed as adipokine and inflammatory determinants of fibrinolytic function. PAI-1 antigen levels were significantly elevated in metabolic syndrome patients (mean 48.4 ng/mL vs 21.3 ng/mL in controls), associated with prolonged ECLT, indicating impaired fibrinolysis. t-PA antigen was paradoxically elevated, consistent with endothelial activation, but the elevated PAI-1 suppressed net fibrinolytic activity. D-dimer and fibrinogen were both elevated in metabolic syndrome patients. PAI-1 correlated significantly with waist circumference, triglycerides, and HOMA-IR insulin resistance scores. Adiponectin showed a significant negative correlation with PAI-1, confirming its protective role in fibrinolysis. The findings establish impaired fibrinolysis as a significant thrombotic risk in Nigerian metabolic syndrome patients and support PAI-1 measurement in metabolic risk assessment. Keywords: fibrinolysis, PAI-1, metabolic syndrome, obesity, Kano State.