Open AccessCirculating PCSK 9 is lowered acutely following surgery
Author(s) -
Druce Irena,
Abujrad Hussein,
Chaker Seham,
Meggison Hilary,
Hill Andrew,
Raymond Angela,
Mayne Janice,
Ooi Teik Chye
Publication year - 2018
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22358
Subject(s) - kexin , medicine , pcsk9 , endocrinology , lipoprotein , cholesterol , low density lipoprotein , high density lipoprotein , ldl receptor
Background A decrease in serum low‐density lipoprotein cholesterol ( LDL ‐C) is well documented after acute stress. Plasma proprotein convertase subtilisin kexin 9 ( PCSK 9), which promotes degradation of low‐density lipoprotein receptor ( LDL ‐R) resulting in reduced plasma clearance of low‐density lipoproteins ( LDL ) and an increase in serum LDL ‐C, would be predicted to decrease. Yet, a few studies have demonstrated an increase 1‐8 days after acute stress. Our objective was to assess the earlier status of plasma PCSK 9, within the first 24 hours of onset of stress. Methods We measured serum lipids and plasma PCSK 9 in 39 patients before and soon after an elective surgical procedure (abdominal aortic aneurysm ( AAA ) repair). Results We observed an early decrease in PCSK 9 following surgery, as well as a decrease in total cholesterol ( TC ), LDL ‐C, high‐density lipoprotein cholesterol ( HDL ‐C), non–high‐density lipoprotein cholesterol (non‐ HDL ‐C) and triglycerides ( TG ). Conclusion Unlike other studies which showed an increase in PCSK 9 after the onset of stress, our study detected a fall in PCSK 9 following acute surgical stress. The observed difference is likely due to the earlier timing of PCSK 9 measurement in our study. Further studies involving serial poststress measurements for several days are needed to determine whether PCSK 9 behaves as an acute‐phase reactant, whether it displays a biphasic response to acute stress, and whether changes in circulating PCSK 9 are responsible for lipoprotein changes observed after surgical stress. (Clinical Trial Registration: ClinicalTrials.gov study ID NCT 00493389)