Association of circulating proprotein convertase subtilisin/kexin type 9 concentration with coagulation abnormalities in patients with primary membranous nephropathy

Abstract

Objectives

The aims of the study were to explore the potential associations between plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) and coagulation indexes in patients with primary membranous nephropathy (PMN).

Methods

A total of 87 patients diagnosed with PMN were enrolled in our study. 30 healthy participants were recruited to match PMN participants. Plasma PCSK9 concentrations were tested by enzyme-linked immunosorbent assay (ELISA). Correlations between PCSK9 and coagulation abnormalities in patients with PMN were analyzed using univariate and multiple linear regression analysis.

Results

Plasma PCSK9 levels in patients with PMN were significantly higher than that in healthy controls [232.0 (143.5, 359.5) ng/mL vs. 166.8 (129.7, 199.7) ng/mL; p = 0.001]. Plasma levels of PCSK9 were positively correlated with factor VIII, factor IX, factor XI, log-transformed tissue factor, protein C and protein S (r = 0.267, p = 0.013; r = 0.496, p < 0.001; r = 0.217, p = 0.045; r = 0.584, p < 0.001; r = 0.372, p = 0.001; r = 0.282, p = 0.011). In multiple linear regression analysis, PCSK9 concentration was independently and positively correlated with factor VIII, factor IX, and tissue factor (β = 0.186, p = 0.047; β = 0.325, p = 0.001; β = 0.531, p < 0.001; respectively). PCSK9 concentration was independently and negatively correlated with PT (β= −0.343, p = 0.011).

Conclusion

Plasma PCSK9 levels had good positive correlations with procoagulant clotting factors and negative correlations with PT in PMN, which might provide novel information with regard to PCSK9 and hypercoagulability in PMN.

Keywords:

• Primary membranous nephropathy
• PCSK9
• coagulation abnormalities
• hypercoagulability

Acknowledgements

The authors thank the nurses of the Department of Nephrology of Shandong Provincial Hospital Affiliated with Shandong First Medical University for their support in collecting data from this work.

Ethics approval and consent to participate

This study was approved by the ethics committee of Shandong Provincial Hospital affiliated to Shandong First Medical University (the approval number is SZRJJ:NO.2022-111).

Author contributions

Huizi Zhu drafted the manuscript, did the ELISA work, and collected the clinical data, and analysis. Qian Meng drafted the manuscript, collected the clinical data, and analysis. Xiang Liu participated in collecting the related clinical and pathological data. Chunjuan Zhai did the statistical analysis. Jing Sun and Rong Wang did the whole revision process. Liang Xu acted as the co-corresponding author and did the study design and manuscript revision. Xiaowei Yang acted as the corresponding author, and did the whole study design and the manuscript revision.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by grants of Taishan Scholars Program of Shandong Province [No. ts201712090], Academic promotion programme of Shandong First Medical University [No. 2019QL022], and China international medical foundation [No. Z-2017-24-2037].