U.O. Lipoapheresis and Center for Inherited Dyslipidemias, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
Fondazione Stella Maris, IRCCS Istituto Scientifico per la Neuropsichiatria dell'Infanzia e dell'Adolescenza, Pisa, Italy.
Hormones (Athens). 2024 Mar;23(1):137-140. doi: 10.1007/s42000-023-00504-z. Epub 2023 Nov 24.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a regulator of low-density-lipoprotein cholesterol (LDL-C), a major risk factor for cardiovascular (CV) disease. Since the hormone leptin has been suggested as having a role in CV risk regulation, possibly by modulating LDL receptor expression through the PCSK9 pathway, nutritional status may represent a potential regulator. Thus, evaluation of PCSK9 levels in human eating disorders appears to be of interest. In this report, we evaluate the lipoprotein profile, PCSK9, and leptin levels in subjects affected by anorexia nervosa (AN) to improve our understanding of the metabolic alterations in this disease.
We designed a case-control observational study, enrolling 20 anorexic adolescent females and 20 adolescent females without AN as the control group, age- and sex-matched. Subjects affected by AN showed lower BMI, total cholesterol, and LDL-C in comparison to the control group, with lipoprotein levels in the normal range. Furthermore, adolescent girls with AN show significantly higher PCSK9 (+24%, p < 0.005) and lower leptin levels (-43%, p < 0.01), compared to the control group.
The findings of increased levels of PCSK9 and reduced leptin levels among AN subjects warrant further research in order to unravel the role of the liver and adipose tissue in the management of PCSK9/LDL metabolism in adolescents affected by AN.
前蛋白转化酶枯草溶菌素/ kexin 9 型(PCSK9)是一种调节低密度脂蛋白胆固醇(LDL-C)的物质,LDL-C 是心血管疾病(CV)的主要危险因素。由于瘦素被认为具有调节 CV 风险的作用,可能通过 PCSK9 途径调节 LDL 受体的表达,营养状况可能是一个潜在的调节因素。因此,评估人类饮食失调患者的 PCSK9 水平似乎很有意义。在本报告中,我们评估了厌食症(AN)患者的脂蛋白谱、PCSK9 和瘦素水平,以加深对该疾病代谢改变的认识。
我们设计了一项病例对照观察研究,纳入了 20 名患有厌食症的青春期女性和 20 名年龄和性别相匹配的无 AN 的青春期女性作为对照组。与对照组相比,患有 AN 的患者 BMI、总胆固醇和 LDL-C 较低,脂蛋白水平处于正常范围。此外,与对照组相比,患有 AN 的青春期女孩的 PCSK9 水平显著升高(+24%,p < 0.005),瘦素水平显著降低(-43%,p < 0.01)。
AN 患者 PCSK9 水平升高和瘦素水平降低的发现需要进一步研究,以阐明肝脏和脂肪组织在管理 AN 青少年 PCSK9/LDL 代谢中的作用。