SERPINE1 and endothelial dysfunction: Thus, subjects who have abdominal obesity, atheroslcerosis, insulin resistance and hyperinsulinemia, hyperlipidemias, endothelial dysfunction, essential hypertension, type 2 diabetes mellitus, and coronary heart disease (CHD) are considered to have metabolic syndrome X. Other features of metabolic syndrome X also include: hyperfibrinogenemia, increased plasminogen activator inhibitor-1 (PAI-1), low tissue plasminogen activator, nephropathy, micro-albuminuria, and hyperuricemia.