Influence of physiological changes in endogenous estrogen on circulating PCSK9 and LDL cholesterol

J Lipid Res. 2015 Feb;56(2):463-9. doi: 10.1194/jlr.M055780. Epub 2014 Dec 22.

Abstract

Pharmacologically increased estrogen levels have been shown to lower hepatic and plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) levels in animals and humans. We hypothesized that physiological changes in estrogen levels influence circulating PCSK9, thereby contributing to the known wide inter-individual variation in its plasma levels, as well as to the established increase in LDL cholesterol (LDL-C) with normal aging. Circulating PCSK9, estradiol, and other metabolic factors were determined in fasting samples from 206 female and 189 male healthy volunteers (age 20-85 years), The mean levels of PCSK9 were 10% higher in females than in males (P < 0.05). PCSK9 levels were 22% higher in postmenopausal than in premenopausal (P < 0.001) females. Within the group of premenopausal females, circulating PCSK9 correlated inversely to estrogen levels, and PCSK9 was higher (305 ng/ml) in the follicular phase than in the ovulatory (234 ng/ml) or the luteal (252 ng/ml) phases (P < 0.05). Changes in endogenous estrogen levels during the menstrual cycle likely contribute to the broad inter-individual variation in PCSK9 and LDL-C in normal females. PCSK9 levels increase in females after menopause but not in men during this phase in life. This likely contributes to why LDL-C in women increases in this period.

Keywords: low density lipoprotein cholesterol; menopause; menstruation cycle; proprotein convertase subtilisin/kexin type 9.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cholesterol, LDL / blood*
  • Cholesterol, LDL / metabolism
  • Estrogens / blood*
  • Estrogens / metabolism
  • Female
  • Humans
  • Male
  • Menstrual Cycle / physiology
  • Middle Aged
  • Proprotein Convertase 9
  • Proprotein Convertases / blood*
  • Proprotein Convertases / metabolism
  • Serine Endopeptidases / blood*
  • Serine Endopeptidases / metabolism
  • Sex Factors
  • Young Adult

Substances

  • Cholesterol, LDL
  • Estrogens
  • PCSK9 protein, human
  • Proprotein Convertase 9
  • Proprotein Convertases
  • Serine Endopeptidases