Circulating PCSK9 as a prognostic biomarker of cardiovascular events in individuals with type 2 diabetes: evidence from a 16.8-year follow-up study

Cardiovascular Diabetology

Research

Deborah Ramini¹  Stefano Carugo²  Alessandra Stefania Rizzuto³  Angelica Giuliani⁴  Matilde Sbriscia⁴  Fabiola Olivieri⁵  Jacopo Sabbatinelli⁶  Alberto Corsini⁷  Chiara Macchi⁷  Massimiliano Ruscica⁸  Anna Rita Bonfigli⁹ 

[1]Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy

[2]Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

[3]Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy

[4]Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy

[5]Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Via Tronto 10/A, 60126, Ancona, Italy

[6]Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Via Tronto 10/A, 60126, Ancona, Italy

[7]Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy

[8]Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Via Tronto 10/A, 60126, Ancona, Italy

[9]Laboratory Medicine Unit, Azienda Ospedaliero Universitaria Delle Marche, Ancona, Italy

[10]Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Milan, Italy

[11]Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Milan, Italy

[12]Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

[13]Scientific Direction, IRCCS INRCA, Ancona, Italy

关键词: Proprotein Convertase Subtilisin/kexin type 9;    Type 2 diabetes mellitus;    Cardiovascular risk;    Major adverse cardiovascular events;    All-cause mortality;   

DOI  :  10.1186/s12933-023-01948-8

 received in 2023-07-05, accepted in 2023-07-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAtherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality, being twofold to fourfold more common in patients with type 2 diabetes mellitus (T2DM) than in individuals without diabetes. However, despite this decade-old knowledge,the identification of a specific prognostic risk biomarker remains particularly challenging.MethodsTaking advantage of a large sample of Caucasian patients (n = 529) with a diagnosis of T2DM followed for a median of 16.8 years, the present study was aimed at testing the hypothesis that fasting serum proprotein convertase subtilisin/kexin type 9 (PCSK9) levels could be prognostic for major adverse cardiovascular events (MACE) and all-cause mortality.ResultsMedian levels of PCSK9 were 259.8 ng/mL, being higher in women compared to men and increasing even more in the presence of a complication (e.g., diabetic kidney disease). PCSK9 positively correlated with markers of blood glucose homeostasis (e.g., HbA1c, fasting insulin and HOMA-IR) and the atherogenic lipid profile (e.g., non-HDL-C, apoB and remnant cholesterol). Serum PCSK9 predicted new-onset of MACE, either fatal or non-fatal, only in women (Odds Ratio: 2.26, 95% CI 1.12–4.58) and all-cause mortality only in men (Hazard Ratio: 1.79, 95% CI 1.13–2.82).ConclusionsConsidering that up to two-thirds of individuals with T2DM develop ASCVD in their lifetime, the assessment of circulating PCSK9 levels can be envisioned within the context of a biomarker-based strategy of risk stratification. However, the sex differencefound highlights an urgent need to develop sex-specific risk assessment strategies.Trial registration: It is a retrospective study.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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