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Background  Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of serum low-density lipoprotein (LDL) cholesterol levels. Recently, PCSK9 has additionally been related to metabolic risk factors such as the levels of triglycerides, apolipoprotein B (apoB), insulin, and glucose, as well as body mass index. The purpose of this study was to investigate correlations between serum levels of PCSK9 and apoB-containing atherogenic lipoproteins in patients with coronary artery disease (CAD).    Methods  Serum levels of PCSK9 and lipoprotein(a) [Lp(a)]; small, dense LDL; and oxidized LDL were measured in 101 patients with CAD who were not receiving lipid-lowering therapy.    Results  Serum hetero-dimer PCSK9 levels were positively correlated with serum levels of Lp(a) ( r  = 0.195,  p  = 0.05); small, dense LDL ( r  = 0.336,  p  = 0.0006); and oxidized LDL ( r  = 0.268,  p  = 0.008). Multivariate regression analyses showed that serum hetero-dimer PCSK9 was a significant predictor of serum levels of Lp(a) ( β  = 0.235,  p  = 0.01); small, dense LDL ( β  = 0.143,  p  = 0.03); and oxidized LDL ( β  = 0.268,  p  = 0.008).    Conclusions  Serum PCSK9 levels were positively correlated with serum levels of Lp(a); small, dense LDL; and oxidized LDL in patients with CAD. This suggests that the interaction between serum PCSK9 and apoB-containing lipoproteins plays a role in establishing the atherosclerotic status of patients.    Trial registration  UMIN Clinical Trials Registry, UMIN ID:  C311 .

lipids in health and disease

Correlation between serum levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) and atherogenic lipoproteins in patients with coronary artery disease