Background: Plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) levels were found associated with not only lipid profiles, but also glucose homeostasis. Nevertheless, the relationship between PCSK9 levels, and diabetes was inconsistent in various studies.

Objective: To investigate the plasma PCSK9 levels among normoglycemia, pre-diabetes, and T2DM patients with, and without statin therapy in Thais.

Materials and Methods: Five hundred fifty-three subjects including 213 normoglycemia, 176 pre-diabetes, 46 T2DM without statin therapy, 40 T2DM with simvastatin therapy at 20 mg/day, and 78 T2DM with simvastatin therapy at 40 mg/day were recruited. Anthropometric data, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), and PCSK9 levels were measured.

Results: PCSK9 levels were significantly higher in T2DM without statin therapy compared with normoglycemic subjects. In addition, T2DM with simvastatin therapy (40 mg/day) had significantly higher PCSK9 levels than T2DM without statin therapy, and T2DM with simvastatin therapy (20 mg/day). Serum PCSK9 levels were positively correlated with several metabolic parameters including age, body mass index (BMI), systolic blood pressure (SBP), TC, TG, and FBS (p<0.05) in the present study subjects.

Conclusion: PCSK9 levels were modulated by glycemic status, and statin therapy in Thai subjects. Elevation of plasma PCSK9 levels in T2DM with, and without statin therapy may increase the risk for dyslipidemia, and cardiovascular disease among T2DM patients.

Keywords: PCSK9, Pre-diabetes, T2DM, FBS, Statin

DOI: 10.35755/jmedassocthai.2023.03.13803

Received 13 June 2022 | Revised 30 December 2022 | Accepted 9 January 2023