Relationship between testosterone, estradiol and circulating PCSK9: Cross-sectional and interventional studies in humans

• Published in: Clinica chimica acta Vol. 446; pp. 97 - 104
• Main Authors: Ooi, T.C., Raymond, A., Cousins, M., Favreau, C., Taljaard, M., Gavin, C., Jolly, E.E., Malone, S., Eapen, L., Chretien, M., Mbikay, M., Mayne, J.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.06.2015
• Subjects: Adult; Cohort Studies; Cross-Sectional Studies; Early Medical Intervention - trends; Estradiol; Estradiol - blood; Estrogen Replacement Therapy - trends; Female; Gender; Humans; LDL-cholesterol; Male; Middle Aged; PCSK9; Proprotein Convertase 9; Proprotein Convertases - blood; Serine Endopeptidases - blood; Sex Characteristics; Testosterone; Testosterone - administration & dosage; Testosterone - blood; LDL-cholesterol; Testosterone; PCSK9; Gender; Estradiol
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2015.03.036

Circulating PCSK9 levels are higher in women than men, in postmenopausal than premenopausal women, and in pregnant than non-pregnant women, suggesting that sex hormones may be related to PCSK9 levels. We have examined the relationship between serum estradiol (E2) and testosterone (T) and PCSK9, and the impact of E2 replacement therapy in women and T replacement and ablation therapy in men on circulating PCSK9. We conducted a cross-sectional study to examine the correlation between serum T (in males) and E2 (in females) and serum PCSK9. We also conducted interventional studies to examine the effect of hormonal therapy on serum PCSK9 levels. In men, (1) serum T does not correlate with circulating PCSK9 or with LDLC in the basal state, (2) T replacement therapy does not have any effect on circulating PCSK9, and (3) T ablation therapy has mixed results. In women, (1) E2 correlates inversely with circulating PCSK9 and directly with serum LDLC, but (2) E2 replacement therapy does not have any effect on circulating PCSK9. We demonstrate differences between men and women in the relationship of their major sex hormones with circulating PCSK9. In men, circulating PCSK9 is not related to or affected by T except for a possible effect during T ablation therapy. In women, E2 is inversely related to circulating PCSK9 but the lack of effect of E2 therapy on circulating PCSK9 suggests that the E2-related differences in PCSK9 levels may be the result of differences in receptor-mediated PCSK9 clearance through E2-induced changes rather than production of PCSK9. The studies were registered with ClinicalTrials.gov NCT00848276. •In men serum T does not correlate with PCSK9 and T therapy does not alter PCSK9.•In women E2 correlates inversely with PCSK9 but E2 therapy does not alter PCSK9.•Lack of E2 effect suggests changes in PCSK9 clearance rather than production.