high-intensity interval training modulates thrombotic susceptibility in metabolic syndrome: attenuation of plasma pai-1 and fibrinogen via ameliorated metabolic dysfunction

Metabolic syndrome (mets) elevates thrombotic risk through dysregulated coagulation factors, including plasminogen activator inhibitor-1 (pai-1) and fibrinogen, driven by visceral adiposity and metabolic dysfunction. high-intensity interval training (hiit) improves cardiometabolic health, but its effects on hemostatic markers in mets remain underexplored. twenty-four men with mets (atp-iii criteria; age 44.4 ± 5.4 years, bmi 31.7 ± 2.3 kg·m⁻²) were randomized to hiit (n=12) or control (n=12). hiit comprised 3 sessions/week for 8 weeks (4 × 4-min intervals at 90% hrmax, interspersed with 3-min active recovery at 70% hrmax). fasting plasma pai-1, fibrinogen, insulin resistance (homa-ir), body composition, and lipid profiles were assessed pre/post-intervention. hiit significantly reduced pai-1 (−30.7%, p<0.001) and fibrinogen (−21.8%, p<0.001) versus controls. concurrent improvements occurred in homa-ir (−20.6%, p<0.001), body fat (−3.8%, p<0.05), systolic/diastolic bp (−7.5%/−5.2%, p<0.05), ldl-c (−5.6%), triglycerides (−9.4%), and hdl-c (+3.0%; all p<0.05). control group exhibited no significant changes. hiit attenuates prothrombotic risk in mets, evidenced by reductions in pai-1 and fibrinogen. these hemostatic improvements are mechanistically linked to ameliorated metabolic dysfunction, highlighting hiit’s role in modulating adipose tissue–vascular cross talk.