BackgroundPlasma plasminogen activator inhibitor-1 (PAI-1) is thought to contribute to the pathogenesis of atherosclerosis and is a predictor of ischemic heart disease.MethodsWe investigated the effects of overweight/obesity and lifestyle (smoking and alcohol intake) on plasma PAI-1 levels in 203 healthy men (age 44.5 ± 8.1) who visited our department for health check. Information on alcohol intake and smoking habit was obtained by a questionnaire.ResultsPlasma PAI-1 was significantly correlated to plasma leptin, body mass index (BMI), percent body fat, plasma levels of triglyceride, and &ggr;-glutamyl transpeptidase. Plasma PAI-1 was also increased significantly in smokers and in heavy drinkers. Plasma PAI-1 levels increased in an additive manner by the combination of risk factors (BMI ≥25 kg/m2, smoking, and heavy alcohol consumption). Nonobese, nonsmoking, nondrinkers showed the lowest plasma PAI-1 levels, whereas overweight/obese, smoking, heavy drinkers showed the highest levels (11.2 ± 2.2 ng/mL versus. 34.0 ± 4.3 ng/mL,P< 0.0001).ConclusionThese results suggest that overweight/obesity and unfavorable lifestyle such as smoking and heavy alcohol consumption may increase plasma PAI-1 levels and might be linked to the risk of ischemic heart disease.