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Jia F, Fei SF, Tong DB, Xue C, Li JJ. Sex difference in circulating PCSK9 and its clinical implications. Front Pharmacol 2022; 13:953845. [PMID: 36160427 PMCID: PMC9490038 DOI: 10.3389/fphar.2022.953845] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/08/2022] [Indexed: 12/04/2022] Open
Abstract
Proprotein convertase subtilisin kexin type 9 (PCSK9) is a proprotein convertase that increases plasma low-density lipoprotein cholesterol (LDL-C) levels by triggering the degradation of LDL receptors (LDLRs). Beyond the regulation of circulating LDL-C, PCSK9 also has direct atherosclerotic effects on the vascular wall and is associated with coronary plaque inflammation. Interestingly, emerging data show that women have higher circulating PCSK9 concentrations than men, suggesting that the potential roles of PCSK9 may have different impacts according to sex. In this review, we summarize the studies concerning sex difference in circulating levels of PCSK9. In addition, we report on the sex differences in the relations of elevated circulating PCSK9 levels to the severity and prognosis of coronary artery disease, the incidence of type 2 diabetes mellitus, and neurological damage after cardiac arrest and liver injury, as well as inflammatory biomarkers and high-density lipoprotein cholesterol (HDL-C). Moreover, sex difference in the clinical efficacy of PCSK9 inhibitors application are reviewed. Finally, the underlying mechanisms of sex difference in circulating PCSK9 concentrations and the clinical implications are also discussed.
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Affiliation(s)
- Fang Jia
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Si-Fan Fei
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - De-Bing Tong
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Cong Xue
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
- *Correspondence: Cong Xue, ; Jian-Jun Li,
| | - Jian-Jun Li
- Cardio-Metabolic Center, Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- *Correspondence: Cong Xue, ; Jian-Jun Li,
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Liu H, Zou L, Zhou R, Zhang M, Gu S, Zheng J, Hukportie DN, Wu K, Huang Z, Yuan Z, Wu X. Long-Term Increase in Cholesterol Is Associated With Better Cognitive Function: Evidence From a Longitudinal Study. Front Aging Neurosci 2021; 13:691423. [PMID: 34220488 PMCID: PMC8248815 DOI: 10.3389/fnagi.2021.691423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Higher visit-to-visit cholesterol has been associated with cognitive decline. However, the association between long-term increase or decrease in cholesterol and cognitive decline remains unclear. Methods: A total of 4,915 participants aged ≥45 years with normal cognition in baseline were included. The participants were divided into four groups, namely low-low, low-high, high-low, and high-high, according to the diagnostic thresholds of total cholesterol (TC), non-high-density lipoprotein cholesterol (NHDL-C), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C) after 4 years of follow-up. Cognitive function was assessed by episodic memory and mental intactness. Binary logistic regression was used to analyse the association of cholesterol variation with cognitive decline. Results: Among the participants, 979 (19.9%) experienced global cognitive decline. The odds ratio (OR) of global cognitive and memory function decline were remarkably lower in participants in the low-high NHDL-C group than those in the low-low group [OR and 95% confidence interval (CI): 0.50 [0.26-0.95] for global cognitive decline, 0.45 [0.25-0.82] for memory function decline]. The lower OR was also significant in females (OR [95% CI]: 0.38 [0.17-0.87] for global cognitive decline; 0.44 [0.19-0.97] for memory function decline) and participants without cardiovascular disease (OR [95% CI]: 0.31 [0.11-0.87] for global cognitive decline; 0.34 [0.14-0.83] for memory function decline). The increases in other cholesterol were also negatively associated with the risk of cognitive decline although not significantly. Conclusions: A longitudinal increase in NHDL-C may be protective for cognition in females or individuals without cardiovascular disease.
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Affiliation(s)
- Huamin Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Lianwu Zou
- Department of Psychiatry, Baiyun Psychiatric Rehabilitation Hospital, Guangzhou, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Minyi Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Shanyuan Gu
- Inpatient Department, Baiyun Psychiatric Rehabilitation Hospital, Guangzhou, China
| | - Jiazhen Zheng
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Daniel Nyarko Hukportie
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Keyi Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhiwei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zelin Yuan
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xianbo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
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