Combined intake of glucose-and lipid-lowering medications further elevates plasma levels of PCSK9 in type 2 diabetes patients.

BACKGROUND AND AIM: This study examined the status of plasma levels of protein convertase subtilisin/kexin 9 (PCSK9) in association with glucose-and lipid-lowering medications in subjects with type 2 diabetes (T2D).

METHODS

This study comprised 177 diabetics and 115 non-diabetic subjects recruited from the United Arab Emirates National Diabetes Study (UAEDIAB). Clinical and biomedical data were collected by standard techniques. Plasma levels of PCSK9 were determined using ELISA.

RESULTS

PCSK9 levels were higher in diabetics than non-diabetics (P < 0.001). Diabetics with disease duration >5 years, HbA1c > 7.0%, or male subjects, had significantly higher levels of PCSK9 than their counterparts (P < 0.05). Regression analysis revealed that HbA1c and age are predictors for PCSK9 in T2D subjects. Diabetic subjects with abnormal lipids profile on lipid-lowering medications had a higher level of PCSK9 compared to those with normal lipids profile (85.6 ± 40.5 vs. 63.7 ± 39.5 ng/ml, respectively; P < 0.01). Diabetics on combined intake of insulin and oral glucose-lowering drugs had higher levels of PCSK9 than those not taking any (86.1 ± 41.6 vs 69.7 ± 36.1 ng/ml, respectively; P < 0.05). The highest levels of PCSK9 however, were in diabetics on combined lipid- and glucose-lowering therapy when compared to those, not on any (96.2 ± 34.0 vs 66.0 ± 35.1 ng/ml, respectively; P < 0.01).

CONCLUSIONS

Age and HbA1c are the most predictors for the elevated levels of PCSK9 in Emirati T2D subjects. Combined therapy of glucose-and lipid-lowering medications further elevates plasma levels of PCSK9 in diabetic subjects.