Abstract
It has been well-established that obesity is the major contributing factor for the development of metabolic syndrome (MetS), diabetes, cardiovascular disease and certain types of cancer. According to WHO, 44% increase of diabetes, 23% increase of ischaemic heart disease, and between 7% and 41% increase of certain cancer are due to obesity. The Middle East region is reported to have the highest prevalence of diabetes in adults in the world. In Saudi Arabia, over 35% of the population are obese, and it is estimated that 24% of adult has diabetes including undiagnosed diabetes cases. Obesity and chronic metabolic disease associated obesity impose the heavy financial burden on national healthcare in the Gulf countries as they do in most countries worldwide. Biochemical markers for MetS included changes in trace elements, vitamin D, hormonal (adipokines, leptin, adiponectin, ghrelin), inflammatory mediators (IL-6, TNF-alpha, IL-10), biochemical markers (Ox-LDL, uric acid) and prothrombic factors (PAI-1). Plasminogen Activator Inhibitor-1 (PAI-1) is the primary of four serine peptidase inhibitors that functions to modulate extracellular matrix remodeling and fibrinolysis. The link between PAI-1 and MetS has been established. This review screening major factors and the association between PAI-1, trace elemnts, vitamin D, obesity hormone and expression of obesity genes for early prediction of MetS for control and management to prevent late complications.