Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.
Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.
Biomolecules. 2023 Sep 12;13(9):1384. doi: 10.3390/biom13091384.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates lipid metabolism contributing to cardiovascular (CV) risk in the general population. The relationship between PCSK9 and CV risk in systemic autoimmune diseases has been poorly explored. We investigated the association between plasma PCSK9, measures of immune-inflammatory status and markers of atherosclerosis in 52 consecutive patients with primary Sjögren's syndrome (pSS) in comparison to healthy controls (HCs). Median plasma PCSK9 levels were significantly higher in pSS patients versus HCs (162 (79-255) vs. 53 (39-99) ng/mL). Significantly higher prevalence of subclinical atherosclerosis and lower of dyslipidaemia (61% vs. 85%, = 0.042) characterized pSS patients versus HCs. In pSS, no significant correlation emerged between PCSK9 and disease activity, atherosclerosis and lipid levels. In HCs, PCSK9 significantly correlated with lipid levels and atherosclerosis. Interestingly, significantly higher PCSK9 levels were found in HCs with high-to-very-high as compared to low-to-moderate CV risk ( = 0.018) while a non-significant trend towards higher PCSK9 levels was detected in pSS patients with low-to-moderate as compared to high-to-very-high CV risk ( = 0.060). This is the first demonstration that pSS patients, despite lower prevalence of dyslipidaemia and higher CV risk profile, are characterized by a 3-fold increase in PCSK9 levels in comparison to HCs. As PCSK9 does not correlate with measures of CV risk, its role in CV morbidity in pSS needs further investigation.
前蛋白转化酶枯草溶菌素/糜蛋白酶 9（PCSK9）调节脂质代谢，从而导致普通人群的心血管（CV）风险。PCSK9 与系统性自身免疫性疾病的 CV 风险之间的关系尚未得到充分探索。我们研究了 52 例原发性干燥综合征（pSS）患者与健康对照者（HCs）之间血浆 PCSK9、免疫炎症状态指标与动脉粥样硬化标志物之间的关系。与 HCs 相比，pSS 患者的血浆 PCSK9 水平中位数明显更高（162（79-255）比 53（39-99）ng/mL）。与 HCs 相比，pSS 患者亚临床动脉粥样硬化的患病率更高（61%比 85%， = 0.042），血脂异常的患病率更低。pSS 患者中，PCSK9 与疾病活动度、动脉粥样硬化和血脂水平之间无显著相关性。在 HCs 中，PCSK9 与血脂水平和动脉粥样硬化显著相关。有趣的是，与低至中度 CV 风险相比，高至极高 CV 风险的 HCs 中 PCSK9 水平显著更高（ = 0.018），而 pSS 患者中低至中度与高至极高 CV 风险相比，PCSK9 水平呈升高趋势，但无统计学意义（ = 0.060）。这是首次证明与 HCs 相比，尽管 pSS 患者血脂异常的患病率较低，CV 风险特征较高，但 PCSK9 水平仍升高 3 倍。由于 PCSK9 与 CV 风险指标不相关，因此其在 pSS 患者 CV 发病率中的作用需要进一步研究。
