Adult NAFLD (biopsy-proven and computed tomography-diagnosed) is related to higher serum Plasminogen Activator Inhibitor-1 levels.

The purpose of a systematic review and meta-analysis was to better understand the role of Plasminogen Activator Inhibitor-1 (PAI-1) in non-alcoholic fatty liver disease (NAFLD).

With the aid of a predefined search string, a thorough search of EMBASE, PubMed, and Cochrane Library was carried out. The NHLBI quality assessment methods were used to examine the studies' quality. Mean difference (MD) in serum PAI-1 levels indicated in ng/mL was the major summary result.  The inclusion criteria were met by 33 studies including 10,840 participants, which were then systematically reviewed. The meta-analyses comprised 11 studies.

The MD of PAI-1 levels in NAFLD patients were significantly higher than in controls [17.147 (95% confidence interval (CI): 7.720-26.574)]. Subgroup assessment comparing PAI-1 levels in biopsy-proven NAFLD vs. controls revealed significant results [24.086 (95% CI: 3.812-44.361)]. Profound results were also reported in CT-diagnosed NAFLD [15.523 (95% CI: 7.163-23.883)].

However, there was no significant difference in PAI-1 levels between ultrasound-diagnosed NAFLD patients and controls [10.394 (95% CI: -13.335-34.123)]. PAI-1 levels in NASH patients and controls were not significantly different [26.835 (95% CI: -0.879-54.549)].

To sum up, increased serum PAI-1 levels are linked to adult NAFLD. However, no substantial change was seen in ultrasound-diagnosed NAFLD and NASH people.