Analysis of the Association between PCSK9 Levels and Plasma Lipid Levels in Cameroonians with Type 2 Diabetes

Abstract

Studies have shown that intensive LDL-lowering therapy results in a significant reduction in cardiovascular disease (CVD) risk and improved outcomes. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of LDL cholesterol (LDL-C) and an independent CVD risk marker. PCSK9 has additionally been related to CRP which is also a CVD risk marker. The emerging importance of the inhibition of PCSK9 for the treatment of hypercholesterolemia warrants investigations in different populations. This is the first study evaluating the association between PCSK9 and plasma lipid levels in Sub-Saharan Africa. A Cross sectional analysis was conducted at a major hospital in Yaound9, Cameroon in a cohort of 82 participants (53% females) with median age of 51[42-58] years. There were 28 non-obese type 2 diabetes (T2D) patients with median known duration of diabetes of 3.08[1.06-6.50] years, matched for age and sex to 28 obese nondiabetic and 26 lean nondiabetic subjects. Serum PCSK9 levels were measured using sandwich ELISA method. PCSK9 and hs-CRP levels were significantly higher in obese and T2D subjects relative to the lean controls (p<0.001 and p =0.0respectively). BMI was an independent predictor for PCSK9 and hs-CRP levels and this association remained after adjustment for potential confounders. Lean female subjects had significantly higher PCSK9 levels than males (p=0.004) and positive correlation of PCSK9 with LDL-C and total cholesterol (r=0.4, p=0.048 and r=0.5, p=0.039 respectively). An association was not found between PCSK9 and plasma lipid levels in obese and type 2 diabetes subjects nor was it found between PCSK9 and hs-CRP. Obese and type 2 diabetes subjects have higher PCSK9 and hs-CRP levels when compared to lean controls, suggesting that these metabolic states potentially impact PCSK9 levels in Cameroonian patients. Disclosure C.B.M. Mba: None. W.F. Mbacham: None. E. Sobngwi: None. J. Mbanya: Advisory Panel; Self; GlaxoSmithKline plc.. Speaker's Bureau; Self; Novo Nordisk A/S, Sanofi, Servier.