Supplementation with Octacosanol Affects the Level of PCSK9 and Restore Its Physiologic Relation with LDL-C in Patients on Chronic Statin Therapy

• Published in: Nutrients Vol. 13; no. 3; p. 903
• Main Authors: Ciric, Milica Zrnic, Ostojic, Miodrag, Baralic, Ivana, Kotur-Stevuljevic, Jelena, Djordjevic, Brizita I, Markovic, Stana, Zivkovic, Stefan, Stankovic, Ivan
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10.03.2021; MDPI
• Subjects: Adult; Aged; Aged, 80 and over; Anticholesteremic Agents - therapeutic use; Apolipoproteins; Atorvastatin; Atorvastatin - therapeutic use; Biochemistry; Cholesterol; Cholesterol, LDL - blood; Dietary Supplements; Double-Blind Method; Drug dosages; Dyslipidemias - drug therapy; Fatty Alcohols - administration & dosage; Female; Functional foods & nutraceuticals; Humans; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Kexin; Laboratories; LDL-C; Lipids; Low density lipoprotein; Male; Menaquinones; Middle Aged; Octacosanol; PCSK9; Placebos; Proprotein Convertase 9 - blood; Proprotein convertases; Risk analysis; Risk factors; Risk management; Software; Statins; Sterols; Subtilisin; Sugarcane; supplementation; Vitamin K 2 - administration & dosage; Vitamins - administration & dosage; Serbia; United States > US; supplementation; PCSK9; Octacosanol; LDL-C; statins
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13030903

Dietary supplementation with sugar cane derivates may modulate low-density lipoprotein cholesterol (LDL-C) and proprotein convertase subtilisin/kexin type 9 (PCSK9) levels. The purpose of this study was to determine if dietary supplement (DS), containing Octacosanol (20 mg) and vitamin K2 (45 µg), could restore the disrupted physiologic relation between LDL-C and serum PCSK9. Double-blind, randomized, placebo-controlled, single-center study including 87 patients on chronic atorvastatin therapy was conducted. Eighty-seven patients were randomized to receive DS ( = 42) or placebo ( = 45), and followed for 13 weeks. Serum PCSK9 levels, lipid parameters and their relationship were the main efficacy endpoints. The absolute levels of PCSK9 and LDL-C were not significantly different from baseline to 13 weeks. However, physiologic correlation between % change of PCSK9 and % change of LDL-C levels was normalized only in the group of patients treated with DS ( = 0.409, = 0.012). This study shows that DS can restore statin disrupted physiologic positive correlation between PCSK9 and LDL-C. Elevated PCSK9 level is an independent risk factor so controlling its rise by statins may be important in prevention of cardiovascular events.