Association between lipoprotein (a) and proprotein convertase substilisin/kexin type 9 in patients with heterozygous familial hypercholesterolemia: A case-control study.
BACKGROUND
Recent data have suggested an important role of lipoprotein (a) [Lp(a)] and proprotein convertase substilisin/kexin type 9 (PCSK9) in the development of atherosclerotic cardiovascular disease (ASCVD) in both general population and family hypercholesterolemia (FH), while the relation of Lp(a) to PCSK9 has not been examined.


OBJECTIVE
The aim of the present study was to investigate the association between plasma PCSK9 and Lp(a)in patients with heterozygous FH (HeFH).


METHODS
Two hundred and fifty-five molecularly confirmed patients with HeFH were compared to 255 age- and gender-matched non-FH controls. Plasma PCSK9 and Lp(a) concentrations were measured using ELISA and immunoturbidimetric method respectively, and finally their association was assessed.


RESULTS
Both plasma PCSK9 and Lp(a) levels were significantly higher in patients with HeFH compared to control group (p<0.001). Besides, the Lp(a) concentration and percentage of Lp(a)≥300mg/L were increased by PCSK9 tertiles in HeFH group (both p<0.05) while not in control group. In partial correlation analysis, Lp(a) was associated with PCSK9 (r=0.254, p<0.001) in HeFH group but not in control, which were further confirmed by multivariable linear regression analysis. Furthermore, significant associations between Lp(a) and PCSK9 were also found in subgroups of HeFH group irrespective of definite or probable FH, with and without coronary artery disease (CAD), and with statin or not.


CONCLUSIONS
Plasma Lp(a) level was associated with PCSK9 in patients with HeFH alone, suggesting that much about the interaction of PCSK9 with Lp(a) in FH need further explorations.
['Sun|Di|D|', 'Li|Sha|S|', 'Zhao|Xi|X|', 'Wu|Na-Qiong|NQ|', 'Zhu|Cheng-Gang|CG|', 'Guo|Yuan-Lin|YL|', 'Gao|Ying|Y|', 'Qing|Ping|P|', 'Cui|Chuan-Jue|CJ|', 'Liu|Geng|G|', 'Sun|Jing|J|', 'Dong|Qian|Q|', 'Li|Jian-Jun|JJ|']
D000328:Adult D000368:Aged D000375:Aging D016022:Case-Control Studies D003324:Coronary Artery Disease D004247:DNA D005260:Female D006801:Humans D006938:Hyperlipoproteinemia Type II D008055:Lipids D017270:Lipoprotein(a) D008297:Male D008875:Middle Aged D000071449:Proprotein Convertase 9 D012307:Risk Factors
Lipoprotein (a) Familial hypercholesterolemia Atherosclerosis Proprotein convertase subtilisin/kexin type 9