The relationship level proprotein convertase subtilizin/keksin 9 type with the severity of carotid atherosclerosis in patients with hyperlipidemia

Abstract

Aim. Rate the level of prоprоtein convertase subtilisin/keksin Іуpе 9 (PCSK9) in patients with familial hypercholesterolemia (FHC), verified on the basis of the Dutch and the British, and the criteria to examine the relationship PCSK9 concentration with the severity of atherosclerosis in the carotid arteries. Material and Methods. We studied 220 people, including 84 men and 136 women aged 18 to 75 years (53 + 11years) with total cholesterol (TC) level > 7.5ттоІ/1 and/or low density lipoprotein LDL > 4.9 mmоІ/1. In the Dutch and the British criteria were used to verify the diagnosis of familial hypercholesterolemia (FHC). All included patients underwent duplex scanning carotid arteries on the unit Philips iU22 linear sensor 3-9MGts and determined PCSK9 levels, LDL, Lp (a) in the serum by enzyme-linked immunoelectrodiffusion essay. Results. According to the Dutch and the British criteria in a group of the patients with a certain diagnosis of FHC levels of PCSK9 significantly higher (428.8 ng/ml [334.5 ng/ml; 634 ng/ml] and 426.0 ng/ml [372.4 ng/ml; 681.8 ng/ml], respectively) than in the group of the patients with a likely diagnosis (415 ng/ml [280.2 ng/ml; 472.9 ng/ml], p -0.05 for the Dutch criteria), possible and unlikely diagnosis (343.9 ng/ml [280.2 ng/ml, 411.2 ng/ml], p - 0.0003; 358.8 ng/ml [285.9 ng/ml; 459.3 ng/ml], p - 0.4 respectively). Significant association between PCSK9 and the total percentage of the stenosis of carotid arteries (CA) have been not detected (n - 220; r- 0.07; p = 0.35). When comparing the degree of the stenosis of the CA depending on PCSK9 levels higher levels of PCSK9 was found in the group with stenosis CA 50-100% (428.8 ng/ml [342.3 ng/ml, 523.8 ng/ml than in patients with stenosis of 49% (351 ng/ml [282.7 ng/ml, 446.1 ng/ml (p = 0.02) and without atherosclerotic carotid arteries (349.9 ng/ml [277.6 ng/ml, 417.4 ng/тml (p - 0.03). We found that PCSK9 levels in women is slightly higher than that of men and the concentration was not different in smokers and non-smokers. This article presents the identified significant association with the level of PCSK9 concentrations of TC, LDL-C and Lp(a). Conclusion. The level of PCSK9 significantly higher in patients with a definite diagnosis of FHC and in patients with stenotic lesions of the carotid arteries.