Shi Jie, Li Xiaoyong, Zhang Weiwei, Niu Yixin, Lin Ning, Zhang Hongmei, Ning Guang, Fan Jiangao, Qin Li, Su Qing, Yang Zhen
Department of Endocrinology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Institute of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2021 May 10;8:664583. doi: 10.3389/fcvm.2021.664583. eCollection 2021.
To evaluate the prospective association of circulating PCSK9 levels with the cardiometabolic risk profiles (high LDL-cholesterol, high triglycerides, low HDL-cholesterol, hypertension, type 2 diabetes, and metabolic syndrome). A population-based prospective study was conducted among 7,104 Chinese individuals (age 56.2 ± 7.5 years; 32.0% men). Circulating PCSK9 levels were measured using ELISA. Circulating PCSK9 levels were higher in women than men (286.7 ± 90.1 vs. 276.1 ± 86.4 ng/ml, < 0.001). And circulating PCSK9 was positively correlated with LDL-cholesterol, total cholesterol, and triglycerides both in men and women (all < 0.001). The positive correlation between PCSK9 and waist circumference, fasting glucose, insulin resistance, systolic blood pressure, diastolic blood pressure and C-reactive protein (all < 0.01) was observed in women only. According to Cox regression analysis, circulating PCSK9 was positively associated with incidence of high LDL-cholesterol both in men (HR 1.33, 95% CI 1.09-1.65, < 0.001) and women (HR 1.36, 95% CI 1.12-1.69, < 0.001). Moreover, PCSK9 was significantly associated with incident high triglycerides (HR 1.31, 95% CI 1.13-1.72, < 0.001), hypertension (HR 1.28, 95% CI 1.08-1.53, = 0.011), type 2 diabetes (HR 1.34, 95% CI 1.09-1.76, = 0.005), and metabolic syndrome (HR 1.30, 95% CI 1.11-1.65, = 0.009) per SD change in women only. No statistically significant association was observed between circulating PCSK9 and incidence of low HDL-cholesterol ( > 0.1). Elevated circulating PCSK9 was significantly associated with cardiometabolic risk factors and independently contributed to the prediction of cardiometabolic risks in women.
评估循环中前蛋白转化酶枯草溶菌素9（PCSK9）水平与心血管代谢风险谱（高LDL胆固醇、高甘油三酯、低HDL胆固醇、高血压、2型糖尿病和代谢综合征）之间的前瞻性关联。在7104名中国个体（年龄56.2±7.5岁；32.0%为男性）中进行了一项基于人群的前瞻性研究。使用酶联免疫吸附测定法（ELISA）测量循环PCSK9水平。女性的循环PCSK9水平高于男性（286.7±90.1对276.1±86.4 ng/ml，P<0.001）。并且循环PCSK9在男性和女性中均与LDL胆固醇、总胆固醇和甘油三酯呈正相关（均P<0.001）。仅在女性中观察到PCSK9与腰围、空腹血糖、胰岛素抵抗、收缩压、舒张压和C反应蛋白之间呈正相关（均P<0.01）。根据Cox回归分析，循环PCSK9在男性（风险比[HR]1.33，95%置信区间[CI]1.09 - 1.65，P<0.001）和女性（HR 1.36，95% CI 1.12 - 1.69，P<0.001）中均与高LDL胆固醇的发生率呈正相关。此外，仅在女性中，PCSK9与高甘油三酯的发生（HR 1.31，95% CI 1.13 - 1.72，P<0.001）、高血压（HR 1.28，95% CI 1.08 - 1.53，P = 0.011）、2型糖尿病（HR 1.34，95% CI 1.09 - 1.76，P = 0.005）和代谢综合征（HR 1.30，95% CI 1.11 - 1.65，P = 0.009）每标准差变化显著相关。未观察到循环PCSK9与低HDL胆固醇发生率之间存在统计学显著关联（P>0.1）。循环PCSK9升高与心血管代谢危险因素显著相关，并独立有助于预测女性的心血管代谢风险。
