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A low-glycemic-index diet reduces plasma plasminogen activator inhibitor-1 activity, but not tissue inhibitor of proteinases-1 or plasminogen activator inhibitor-1 protein, in overweight women^1,2,3,4

¹ From the Department of Veterinary Pathobiology (LJ and NB) and the Department of Human Nutrition and the Center for Advanced Food Studies (BS, IK-M, AF, AR, TT, and AA), Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark

Background: The development of obesity has been suggested to involve plasminogen activator inhibitor-1 (PAI-1) and tissue inhibitor of proteinases-1 (TIMP-1). Plasma PAI-1 is elevated in obesity. A low-glycemic-index (LGI) diet may have a beneficial effect on obesity through a decrease in plasma PAI-1, but whether it affects plasma TIMP-1 in healthy humans has not been studied.

Objective: We investigated whether a 10-wk intake of an LGI or a high-glycemic-index (HGI), high-carbohydrate, low-fat, ad libitum diet is associated with decreases in plasma PAI-1 and TIMP-1 concentrations in overweight women.

Design: Forty-four overweight women [body mass index (BMI; in kg/m²): 27.5 ± 0.23] were randomly assigned to consume an HGI or an LGI diet for 10 wk. A subgroup of 29 women was assigned to participate in an additional 4-h meal test on the last day of the 10-wk intervention.

Results: PAI-1 activity decreased after 10 wk of the LGI diet and was significantly different between groups. Changes in PAI-1 antigen followed the same trend, but no significant difference was observed between groups. No difference in plasma TIMP-1 concentrations was observed between groups. PAI-1 and TIMP-1 concentrations after the 4-h meal test were not significantly different between groups.

Conclusion: An LGI diet reduces fasting plasma PAI-1 activity and therefore may be useful for diminishing the adverse cardiovascular effects of obesity. This trial was registered at clinicaltrials.gov as NCT00324090.

Key Words: Plasminogen activator inhibitor-1 • PAI-1 • tissue inhibitor of proteinases-1 • TIMP-1 • glycemic index • obesity • women