• Ana Milojević, Marija Zdravković, Milica Brajković, Lidija Memon, Vera Gardijan, Jelena Vekić, Aleksandra Zeljković, Aleksandra Stefanović, Marija Mihajlović, Jasmina Ivanišević, Nataša Bogavac-Stanojević, Vojislav Radosavljević, Vesna Spasojević-Kalimanovska, and Ana Ninić.
• Department of Laboratory Diagnostics, University Medical Center "Bežanijska Kosa,", Belgrade, Serbia.
• Med Princ Pract. 2022 Jan 1; 31 (3): 293-300.

ObjectivesObstructive sleep apnea (OSA) is a common condition closely related to obesity, insulin resistance, dyslipidemia, and cardiovascular disease. The aim of this study was to explore the possible relationship between OSA and proprotein convertase subtilisin/kexin type 9 (PCSK9).MethodsFull-night polysomnography was performed on 150 participants who were divided into three groups: controls, OSA patients on statin therapy, and OSA patients not on statin therapy. Biochemical markers, plasma low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subclasses, and PCSK9 were determined.ResultsPCSK9 was highest in OSA patients on statins compared to the control group and to OSA patients not on statins (p = 0.036 and p = 0.039, respectively), after adjustment for body mass index (BMI). LDL diameter was greater in OSA patients not on statins compared to OSA patients on statins (p = 0.032). PCSK9 was highest in the group of patients with all three risk factors (diagnosed OSA, statins, BMI ≥25 kg/m2) compared to groups with no, one, and two risk factors (p = 0.031, p = 0.001, and p = 0.029, respectively). Presence of OSA, statin therapy, and BMI ≥25 kg/m2 when combined were independently associated with higher levels of PCSK9 when adjusted for antihypertensive therapy, small dense LDL, and HDL 3c subclass (odds ratio = 2.849; interquartile range [1.026-7.912], p = 0.044).ConclusionStatin therapy was closely related to PCSK9. OSA along with obesity and statin use induces elevation of PCSK9.© 2022 The Author(s). Published by S. Karger AG, Basel.

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