Abstract
Background Elevated proprotein convertase subtilisin/kexin type 9 (PCSK9) levels have been associated with adverse outcomes in patients hospitalized for sepsis. PCSK9 loss-of-function (LOF) variants area associated with lower low-density lipoprotein cholesterol (LDL-C) levels. Decreased LDL-C is a biomarker of acute and chronic infection and sepsis risk. We examined the association between presence of two genetic PCSK9 LOF variants and risk of infection and sepsis in community-dwelling adults. Methods We analyzed data from 10,924 Black participants tested for PCSK9 LOF variants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The primary endpoint was hospitalization for a serious infection. Within serious infection hospitalizations, we defined sepsis as 2 system inflammatory response syndrome criteria. Using multivariable Cox and logistic regression, we investigated the association between LOF variants and hospitalization for infection and sepsis events, adjusting for sociodemographics, health behaviors, chronic medical conditions and select biomarkers. Results Among 10,924 Black participants, PCSK9 LOF variants were present in 244 (2.2%). Serious infection hospitalizations occurred in 779 participants (14 with PCSK9 variants and 765 without). The presence of PCSK9 variants was not associated with infection risk (adjusted HR 0.68; 95% CI: 0.38–1.25). Among participants hospitalized for a serious infection, the presence of PCSK9 variants was not associated with sepsis (adjusted OR 7.31; 95% CI = 0.91–58.7). Conclusions PCSK9 LOF variants are not associated with increased risk of hospitalization for a serious infection. Among those hospitalized for a serious infection, PCSK9 LOF variants was not associated with odds of sepsis.
| Original language | English |
|---|---|
| Article number | e0210808 |
| Journal | PLoS ONE |
| Volume | 14 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2019 |
Bibliographical note
Publisher Copyright:© 2019 Mitchell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding
This study was supported by award R01-NR012726 from the National Institute for Nursing Research, UL1-RR025777 from the National Center for Research Resources, as well as by grants from the Center for Clinical and Translational Science and the Lister Hill Center for Health Policy of the University of Alabama at Birmingham. The parent REGARDS study was supported by cooperative agreement U01-NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Representatives of the funding agencies have been involved in the review of the manuscript but not directly involved in the collection, management, analysis or interpretation of the data. Mr. Moore received grant support from R25-CA4788, the Cancer Prevention and Control Training Program grant, funded by the National Cancer Institute, National Institutes of Health. Ms. Mitchell received grant support from NIH T35HL007473 from the National Institute of Health.
| Funders | Funder number |
|---|---|
| National Institutes of Health (NIH) | |
| National Heart, Lung, and Blood Institute (NHLBI) | T35HL007473 |
| National Institute of Health National Institute of Nursing Research | R01-NR012726 |
| Institute of Neurological Disorders and Stroke National Advisory Neurological Disorders and Stroke Council | U01-NS041588 |
| National Center for Research Resources | UL1-RR025777 |
| University of Alabama, Birmingham | |
| Center for Clinical and Translational Science, University of Illinois at Chicago |
ASJC Scopus subject areas
- General