Is PCSK9 Associated with Plasma Lipid Levels in a Sub-Saharan African Population of Patients with Obesity and Type 2 Diabetes?

Purpose: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of circulating LDL cholesterol. There are inconsistent data in some populations concerning the association between PCSK9, LDL and CRP. The emerging importance of the inhibition of PCSK9 for the treatment of hypercholesterolemia warrants investigations in different populations. The aim of this study from a Sub-Saharan African population was to evaluate the association between PCSK9 and hs-CRP levels and plasma lipid levels in patients with type 2 diabetes (T2D) and obese and lean controls. Patients and methods: A cross-sectional analytical study was conducted in a major hospital in Yaounde, Cameroon in a cohort of 162 participants (53% females). There were 54 non-obese T2D patients matched for age and sex to 54 obese nondiabetic and 54 nondiabetic lean subjects. PCSK9 level was assessed by sandwich ELISA method and hsCRP by nephelometry. Results: PCSK9 and hs-CRP levels were significantly higher in obese and T2D subjects when compared to lean controls (p<0.001 and p=0.002, respectively). The association between PCSK9 and triglyceride levels in the overall population was gender dependent (p=0.04) and subgroup analysis showed a significant positive correlation between PCSK9 and triglyceride levels in males but not in females (r=0.56, p=0.02 and r=0.2 and p=0.1, respectively). Multilinear regression analysis identified BMI as an independent predictor for PCSK9 levels and this association was maintained after adjustment for confounders; adjusted beta-coefficient; 36.1 (95% CI; 29.2-47.4). We did not find an association between PCSK9 and any plasma lipid levels in obese and T2D subjects, nor between PCSK9 and hs-CRP levels. Conclusion: Obese and type 2 diabetes subjects have higher PCSK9 levels when compared to lean controls, suggesting that these metabolic states potentially impact PCSK9 levels in Cameroonian patients.