Serum Levels of PCSK9 Are Increased in Patients With Active Ulcerative Colitis Representing a Potential Biomarker of Disease Activity A Cross-sectional Study

Background/Goal: Ulcerative colitis (UC) is characterized by chronic inflammation and progressive course, with potential extraintestinal complications including cardiovascular mortality. Serum proprotein convertase subtilisin/kexin type 9 (PCSK9) levels have been recently recognized as biomarkers of low-grade inflammation and cardiovascular disease. The aim of our study was to evaluate PCSK9 levels in patients with UC and different degrees of disease activity. Methods: We prospectively recruited consecutive patients with UC attending our center at the University Hospital of Padua. Demographics, clinical characteristics, and biochemical data, including PCSK9, high sensitivity C-reactive protein, and fecal calprotectin, were recorded. Moreover, endoscopic procedures were performed in all subjects. Results: We included 112 patients with UC (mean age=52.62 +/- 12.84 y; 52.62% males). Patients with UC and abnormal fecal calprotectin (>= 250 mu g/g) and/or C-reactive protein (>= 3 mg/L) had greater levels of PCSK9 compared with UC patients with normal fecal calprotectin and high sensitivity C-reactive protein (P=0.03 and 0.005, respectively). Higher endoscopic scores in UC were characterized by greater levels of PCSK9 (P=0.03). Furthermore, we found a positive correlation between PCSK9 levels and fecal calprotectin (r=0.18, P=0.04), endoscopic Mayo Score (r=0.25, P=0.007), and UC-Riley Index (r=0.22, P=0.01). We also found a positive correlation between PCSK9 levels and both total and low-density lipoprotein cholesterol values (P<0.05). Conclusions: Serum PCSK9 levels are increased in patients with biochemical and endoscopic evidence of active disease in UC. Further longitudinal studies are necessary to evaluate the role of PCSK9 as a potential biomarker of disease activity and cardiovascular risk in UC.

Automated summary

This study evaluated the levels of PCSK9 in patients with ulcerative colitis (UC) and their relationship with disease activity. The results showed that patients with abnormal fecal calprotectin and/or C-reactive protein had higher levels of PCSK9. There was a positive correlation between PCSK9 levels and endoscopic scores, fecal calprotectin, and UC-Riley Index. Additionally, PCSK9 levels were positively correlated with cholesterol values.