丙型肝炎病毒感染直接作用抗病毒药物对前蛋白转化酶枯草杆菌蛋白酶/kexin 9型水平的影响。

Effect of directly acting antivirals for hepatitis C virus infection on proprotein convertase subtilisin/kexin type 9 level.

作者信息

Torti Carlo, Scaglione Vincenzo, Cesana Bruno Mario, Costa Chiara, Marascio Nadia, Schiaroli Elisabetta, Busti Chiara, Bastianelli Sabrina, Mazzitelli Maria, Trecarichi Enrico Maria, Francisci Daniela

机构信息

Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences "Magna Graecia" University Catanzaro Italy.

Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometrics and Bioinformatics "Giulio A. Maccacaro", Faculty of Medicine and Surgery University of Milan Milan Italy.

出版信息

Health Sci Rep. 2021 May 2;4(2):e273. doi: 10.1002/hsr2.273. eCollection 2021 Jun.

DOI:10.1002/hsr2.273

PMID:33969232

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8088586/

Abstract

BACKGROUND AND AIMS

Eradication of the hepatitis C virus (HCV) may affect proprotein convertase subtilisin/kexin type 9 (PCSK9) levels and cardiovascular risk. However, information regarding PCSK9 level after HCV eradication is lacking. Hence, in this case-control retrospective study, we aimed to evaluate PCSK9 level from pretherapy baseline up to sustained virological response (SVR).

METHODS

Eighty-four patients treated with directly acting antivirals (DAAs) between July 2015 and May 2018 were enrolled. Differences in baseline PCSK9 level due to absence/presence of recorded baseline characteristics (covariates) were evaluated. Changes in PCSK9 levels from pretherapy to SVR (ΔPCSK9) and their correlations with the covariates were assessed. The repeated measures analysis of variance was used to investigate the differences in PCSK9 level from the baseline to the achievement of SVR due to absence/presence of any covariate.

RESULTS

The mean age of the patients was 67.6 ± 11 years, and 53.6% were males. Baseline PCSK9 levels were statistically lower in patients using statins than in those not using statins (mean, 70.3 ± 43.1 ng/mL vs 271.8 ± 252.2 ng/mL; = .017). PCSK9 level decreased significantly from baseline to the time of SVR (255 ± 248 ng/mL vs 169 ± 188 ng/mL; < .001). PCSK9 levels were statistically higher in the HCV-infected patients at baseline than in the control group (255 ± 248 vs 166.3 ± 120.2 ng/mL; = .020); however, this difference was lost after achieving SVR (mean, 169 ± 188 vs 166.3 ± 120.2 ng/mL; = .464). Changes in PCSK9 level was not statistically related to any of the recorded covariates. The PCSK9 mean level did not differ significantly with absence/presence of any covariate from pretherapy to SVR.

CONCLUSIONS

The reduction in mean PCSK9 level from baseline pretherapy to after HCV eradication was statistically significant. Whether PCSK9 is a new biomarker for cardiovascular risk in these patients remains to be ascertained.

摘要

背景与目的

丙型肝炎病毒（HCV）的根除可能会影响前蛋白转化酶枯草溶菌素/克新9型（PCSK9）水平及心血管疾病风险。然而，目前缺乏关于HCV根除后PCSK9水平的相关信息。因此，在这项病例对照回顾性研究中，我们旨在评估从治疗前基线到持续病毒学应答（SVR）期间的PCSK9水平。

方法

纳入2015年7月至2018年5月间接受直接抗病毒药物（DAA）治疗的84例患者。评估因记录的基线特征（协变量）的有无导致的基线PCSK9水平差异。评估从治疗前到SVR期间PCSK9水平的变化（ΔPCSK9）及其与协变量的相关性。采用重复测量方差分析来研究由于任何协变量的有无导致的从基线到实现SVR期间PCSK9水平的差异。

结果

患者的平均年龄为67.6±11岁，男性占53.6%。使用他汀类药物的患者基线PCSK9水平在统计学上低于未使用他汀类药物的患者（均值分别为70.3±43.1 ng/mL和271.8±252.2 ng/mL；P = 0.017）。从基线到SVR时PCSK9水平显著降低（255±248 ng/mL对169±188 ng/mL；P < 0.001）。HCV感染患者基线时的PCSK9水平在统计学上高于对照组（255±248对166.3±120.2 ng/mL；P = 0.020）；然而，实现SVR后这种差异消失（均值分别为169±188和166.3±120.2 ng/mL；P = 0.464）。PCSK9水平的变化与任何记录的协变量在统计学上均无关联。从治疗前到SVR，PCSK9平均水平在有无任何协变量的情况下均无显著差异。